Junctional escape rhythm ECG interpretation made easy for nursing students, nursing school, NCLEX, and nurses.
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Junctional escape rhythms occur because the SA node (sinoatrial node) is not working properly. As a result, other pacemaker structures in the AV junction begin taking over.
With junctional escape rhythms, you notice that the rate is 4060 bpm and regular. QRS will be narrow (less than 0.12 seconds), QT interval and T wave will be normal.
However, the P wave can have unique characteristics. It can be inverted on aVF, II, and III. It can also be concealed within the QRS, or even after the QRS.
Animation credit: Alila_Medical_Images/pond5
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