Junctional bradycardia EKG examples

Marked sinus bradycardia or SA node exit block can result in an escape AV nodal or junctional bradycardia with narrow QRS complex at a rate of 40-60 beats per minute.

Shown below is an EKG with a nodal escape rhythm. Note the lack of P or P’ waves. Often the P’ wave is hidden in the QRS as the nodal escape conducts down to the ventricle and up to the atrium in a fashion such that the QRS and P’ wave occur simultaneously.

Copyleft images obtained courtesy of ECGpedia, http://en.ecgpedia.org.

Example of junctional escape rhythm / junctional bradycardia on telemetry:

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