Junctional Rhythm

[Tellingfibs]

I have had Paroxysmal Afib since 2017, and take Warfarin and Bisoprolol ( now been 5mgs twice daily for a year ). No other drugs. I have been having a lot of unclassified results on my Kardia lately. A few is normal and I always thought it was interference or similar, or me not being still enough. However, some of them produce what seem to me to be a regular heartbeat at a nice rate ( 58 - 65 ). I was getting so many Unclassifieds that I contacted Kardia. They got me to send one of the results to them ( no charge ) and it came back with the explanation that I must have an arrhythmia that their algorithm doesn’t recognise. I pondered this for a while then sent them another Unclassified that looked ‘normal’ to me, using one of my credits. It has come back with the diagnosis ‘ Junctional Rythmn ‘ . I have never heard of this. Can anyone please tell me what this is and if it is dangerous. I last had an ECG and echocardiogram in the summer and am due this again, and appointment with my cardiologist in July. Thank you good people.

[BobD Volunteer]

Just googled it and according to wikepedia apparently the impulses are coming from the AV node and not the SA node.

[Tellingfibs in reply to BobD]

Thanks Bob. Goodness knows what that means. I do feel relatively looked after with my Afib and this result has ‘thrown’ me a bit. My last Echo in the summer showed no structural change over 5 years and ‘good ventricular function’ so I am inclined not to worry ( unusually for me ! ) Thanks for responding - always good to have you onboard.

[mjames1]

You should send the ekg's to an ep for evaluation and possible treatment.

[Tellingfibs in reply to mjames1]

Thank you for your response. I don’t have the kind of link with my cardiologist where I can just get in touch and send him graphs etc, but his secretary is very helpful so I might pester her. Thanks again.

[stoneyrosed]

Irregular heartbeat that comes from the centre of the heart, not as common as AF, if you don’t notice it or have any symptoms it’s nothing to worry about, but probably worth a mention to your GP who will pass on the message to your consultant.

[Tellingfibs in reply to stoneyrosed]

Thank you stoneyrosed. It’s making me wonder if all my Unclassified results are this arrhythmia, or just the odd one. And all the discussions I see on this forum about Kardia Unclassified results, make me wonder if quite a lot of people have this result lurking. They chat about interference and not keeping still enough, or not making good enough contact with fingers on the pads, but maybe if they enquired further, they may find some of them have this problem too. It does amaze me that over the last nearly six years, reading so much about arrhythmias to educate myself, I have never once seen the term ‘ Junctional Rythmn’ ! Well golly gosh !

[CDreamer in reply to Tellingfibs]

I’ve never heard of it either.

[Tellingfibs in reply to CDreamer]

Perhaps I am not so out of touch after all then CDreamer ! 😊

[stoneyrosed]

I think when we all reach a certain age that most of us have probably got something going on with our hearts, pacs extra beats etc but the majority of people who don’t have symptoms don’t carry these gadgets around with them and so are able to carry on with life without the worries & concerns.

[Tellingfibs in reply to stoneyrosed]

I think you are right. There was I mildly concerned because my Afib has been playing up this last week, then this new possible arrhythmia has got me quite anxious. As always, it’s so good to be in touch with all of you who understand our concerns. Thank you.

[etheral]

By itself it is not dangerous. etheral

[Tellingfibs in reply to etheral]

Thanks etheral. Reassuring 👍

[Hammerboy]

I had PAF until my last ablation in August which , fingers crossed has been successful up to now . I have a 6 lead Kardia mobile and pay a monthly fee to be able to nominate an EP or cardiologist who I can send my readings to for feedback . I had my 3 monthly review in November by zoom call and I sent my EP my last ECG from the Kardia a few days prior to his call . We were able to discuss the ablation and what he saw on the latest reading . He said that if I were to have another episode before my 12 month review I should take another reading and send it over to him using the Kardia App and he’ll take it from there . It’s about £10 per month for this facility and worth it it in my opinion for reassurance and understanding.

[fairgo45]

Do you sometimes take digoxin as this causes junctional rhythm?Apparently the heart rate is between 40-60 bpm.

In afib there usually isn't a p wave so do you have a p wave is it inverted?

I'm not aware that it's dangerous but keep checking regularly and send reports to your cardiologist.

[Palpman in reply to fairgo45]

in a junctional rhythm the pulse starts in the centre of the heart and carry upwards to pulse the atria. This may cause the P wave to be inverse or not seen at all.

Mostly the atrials will beat at the same time as the ventricles due to the central location of the source pulse. This means that the P wave will not always be seen as it hides inside the QRS.

[Tellingfibs in reply to Palpman]

Thanks Palpman. You would think, having had Afib diagnosed and treated for nearly six years now, I would have become familiar with all these P waves, QRS, nodes etc - It’s all like black magic to me still ! I’m not very good at seeing the detail, just the ‘pointy bits’ and how regular they look. I think I need a crash course in reading ECGs …..

[lindat15]

My EP picked this up on one of my ECGs a couple of years ago but didn’t seem that concerned as everything else was normal . Not mentioned it again on more recent reviews.

[Tellingfibs in reply to lindat15]

Ah, interesting. Thanks lindat15.

[BlueINR]

Why not place a call to your cardiologist's office with this question and ask if someone can respond back to you with an answer.

[Tellingfibs in reply to BlueINR]

I think I might do that. Nothing to lose ! 👍

[Tellingfibs]

Thank you DrDave01. I have looked carefully at the strip I sent for analysis and to me ( no medical knowledge at all !) it looks the same as a NSR strip. I will definitely have to get a medic to look because it is stressing me a bit. I hate to think that all my ‘Unclassified’ Kardia readings indicate Junctional Rhythm !

[fairgo45 in reply to Tellingfibs]

Listen to Dr Dave he invented the kardia device

[SeanJax]

Post it here. And we will let you know what rhythm it would be

[Tellingfibs in reply to SeanJax]

Thanks SeanJax but I have no idea how to do that ! 🙄

[JerrysGirl3]

not for nothing but I used to take bisoprolol and then there was a recall and they stopped for quite awhile. Then they came back on the market with a changed formulation. And when I read up on it it did not get good reviews, especially with older people. Did your issues begin when you started taking it? Mine is still sitting in its stapled bag. May be nothing. Look it up and see what it says. From what you said it appears to have started when you started the bisoprolol.

[Tellingfibs in reply to JerrysGirl3]

Hi, I’ve been taking Bisoprolol since 2017 without any problems. The dose was increased last January but still no noticeable problems. I notice though that one of the things that can instigate Junctional Rhythm is beta blockers. Perhaps I’ve had this odd rhythm fo a long time and just not known 🫢 However, I had an ECG and Echocardiogram in the summer. I will mention what you say when I see my cardiologist. Thank you.

[JerrysGirl3 in reply to Tellingfibs]

cardiologist will say "she must have read that online lol!

[JOY2THEWORLD49 in reply to Tellingfibs]

Hi

I reverted to bisoprolol since at 9am my heart beat was 67.

My Dr was on holidAy.

But my ECG two taken 2 weeks apart show bisoprolol NOT

keeping me cONTROLLED.

Dr said back to CCB to be controlled. She said bisoprolol does not

settle my rhythmn or rate.

I an trying CCB Diltiazem without the night 1.25mg Bisoprolol.

Another ECG on Friday and now home she wants 2 x readings daily before

Friday.

At 11pm BP 123/85. 88 H/R

cheri JOY. 74 now. (NZ)

[TracyAdmin Partner]

Junctional rhythm - otherwise known as 'Junctional tachycardia' is a rare, fast heart rhythm that starts in the wrong place in your heart, these may be associated with shortness of breath and fatigue. I would suggest contacting your Doctor at your earliest convenience for further investigation. If you have any questions, please do not hesitate to contact our Patient Services Team: heartrhythmalliance.org/afa...

[Tellingfibs in reply to TracyAdmin]

Thank you for responding. My heart rate was only 63, so a very low Accelerated Junctional Rhythm, and there have been no symptoms other than my usual Afib fluttering now and then. I just wonder how many people just dismiss their Kardia Unclassified readings as I have always done until recently, when I started to get more than usual. Perhaps it is an arrhythmia that goes unnoticed a lot of the time. I will certainly mention it to my doctor, although he is not a fan of Kardia as he believes it can put a lot of focus on your heart when you should go by how you feel. Thanks again for responding.

[TracyAdmin Partner in reply to Tellingfibs]

I agree, its important to check and not ignore any symptoms (or readings) keep a diary of when these events are happening, ready to present to the Doctor. Good luck and stay in touch.