Accelerated Junctional Rhythm

[Luppy1]

I have had 2 SVT ablations the last one being 16 months ago. I have had a few very brief episodes since. A couple of weeks ago I had an odd episode, nothing like I felt before. After this I had an ECG which showed a junctional rhythm but with a rate of 78. Is this common this long after ablation?

[Qwertyky]

6 weeks post ablation for SVT's. I went to the EP and he said I was going in and out junctional rhythm. He wants to wait 2-3 more months before doing another surgery. Maybe my heart needs to heal more. Did anyone have  junctional rhythm go away a month or two after ablation. ???

[is_something_wrong]

Sorry, my post sounded somewhat awful when I read it again. Not the intention to pretend to be an expert on this, I'm really not....

[is_something_wrong]

No, an AVNRT with rate 78 sounds strange. Those rhythms follow a fixed pattern in the heart and even if the speed can vary a bit depending on adrenalin, meds, etc, it sounds a bit weird.

There is a possibility for AVNRT with 1:2 or :1:3 block (the same way atrial flutter works) but that's very uncommon too.

Accelerated juctional rhythm (which occur when the AV node takes over as "pacemaker") is common and possibly easy to mix up with AVNRT if the rate is high enough.

Well, the word tachycardia isn't used for rhythms below 100. Then the word "rhythm" is used instead. You can have junctional bradycardia (below 60, often referred to as escape rhythm), junctional rhythm, between 60 and 100, often referred to as accelerated junctional rhythm, and junctional tachycardia, the same rhythm with rate above 100 (not to be confused with AVNRT)

[Luppy1]

Sorry the last post was unfinished as my Son pressed the enter button!! Anyway, I have never heard of a slow tachycardia!!! I see my Consultant on Dec 5th so will hopefully things will be clearer after that.

[Luppy1]

Thanks to you both for your comments. I have since faxed the ECG to my Consultant who said that although on initial inspection it looked like a junctional rhythm he believes it is in fact a slow AVNRT! A slow tachycardia

[is_something_wrong]

If you had an ablation for AVNRT, this procedure may "annoy" the AV node and for a time make it produce junctional rhythms. This may be one explaination.

Another explaination may be what itdood said, there may be a block between the sinus node and the AV node as a result from the ablation and you should get this further addressed. That would from what I understand, usually cause normal, not accelerated junctional rhythm (rate 40-60), but exceptions do exist.

There are three variants of this: Juctional escape rhythm (rate 40-60) accelerated junctional rhythm (rate 60-100, "overpacing" the sinus node) and junctional tachycardia (rate above 100).

Ask your cardiologist. Take care!

[itdood]

If I'm correct, junctional rhythm indicates that the signal for the ventricles to beat isn't finding its way to the AV node.  The AV junction then initiates the ventricle beat which is also called an "escape rhythm".

I would say that junctional rhythm should be further addressed by your doctor.  It indicates some sort of AV block or the junctional rhythm is inappropriate.