Ver el código de «Junctional tachycardia»

==Background==
*Rare
*Cardiac impulses originate at the AV junction
**AV node
**Bundle of His
*Also referred to as Junctional Ectopic Tachycardia (JET) or Congenital Ectopic Tachycardia (CJET) if present at birth
* Rate exceeds the upper limit seen in normal sinus rhythm
**In adults, >100 bpm 
**In pediatric patients it varies by age until age 8 or 9 (see [[Pediatric vital signs|pediatric vital signs]])

===Junction Rhythm Classification===
''Arbitrarily classified by rate''
*[[Junctional escape rhythm]]: 40-60 bpm
*[[Accelerated junctional rhythm]]: 60-100 bpm
*[[Junctional tachycardia]]: >100 bpm

==Clinical Features==
*Clinical features vary widely, diagnosis usually made via ECG
*Past medical hx may include recent cardiovascular surgery

==Differential Diagnosis==
{{Tachycardia (narrow) DDX}}
{{Tachycardia (wide) DDX}}

==Evaluation==
[[File:Junctional Tachycardia.jpg|thumb|ECG showing junctional tachycardia. Note narrow complex QRS, no P waves, and accelerated rate.]]
*[[ECG]] findings
**P waves
***may be antegrade, retrograde, or absent depending on depolarization of the atrial relative to the ventricles
**QRS complexes
***Narrow in the absence of aberrancy
*May be distinguished from AVNRT via Adenosine administration
**''If JET is present'', atrial depolarization will briefly terminate and reveal AV dissociation
**''If AVNRT is present'', conversion to sinus rhythm will likely occur
**Avoid administration in the setting of aberrancy
**JET will concomitant 3 degree AVB is rare
*Consider JET underlying causes to include
**Electrolyte abnormalities
**Acidosis
**Cardiovascular surgery within 24-48 hrs

==Management==
*[[Amiodarone]] 2 mg/kg bolus.<ref>[pubmed.ncbi.nlm.nih.gov/19632422], Kovacikova L. Amiodarone as a First-Line Therapy for Postoperative Junctional Ectopic Tachycardia. PubMed, National Library of Medicine, Aug 30, 2009.</ref>
**If necessary, as continuous infusion at 10 to 15 mcg/kg/min

==Disposition==


==Medication Dosing==
{{MedicationDose
| drug = Amiodarone
| dose = 2mg/kg bolus, then 10-15mcg/kg/min continuous infusion if needed
| route = IV
| context = First-line antiarrhythmic
| indication = Junctional tachycardia
| population = Adult
}}

==See Also==
*[[Paroxysmal supraventricular tachycardia]]
*[[Tachycardia (Narrow)]]
*[[ACLS: Tachycardia]]
*[[PALS: Tachycardia]]

==External Links==


==References==
<references/>

[[Category:Cardiology]]