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Junctional Escape Complexes by ECG Finding

MedGen UID:
855943
•Concept ID:
C3891157
•
Finding

Definition

An electrocardiographic finding of an escape beat following a pause that originates at the AV junction; this manifests as a QRS complex of supraventricular origin not immediately preceded by a P wave. (CDISC) [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVJunctional Escape Complexes by ECG Finding

Recent clinical studies

Etiology

Temporary cardiac pacemaker in the treatment of junctional rhythm and hypotension due to imipramine intoxication.
Sert A, Aypar E, Odabas D, Aygul MU
Pediatr Cardiol 2011 Apr;32(4):521-4. Epub 2011 Feb 20 doi: 10.1007/s00246-011-9914-y. PMID: 21336976
Late occurrence of heart block after radiofrequency catheter ablation of the septal region: clinical follow-up and outcome.
Pelargonio G, Fogel RI, Knilans TK, Prystowsky EN
J Cardiovasc Electrophysiol 2001 Jan;12(1):56-60. doi: 10.1046/j.1540-8167.2001.00056.x. PMID: 11204085
A comparative study of a modified catheter-mediated direct current and radiofrequency ablation on atrioventricular junction.
Chen SA, Hsia CP, Tsang WP, Wang TC, Ting CT, Wang SP, Chiang BN, Kong CW, Chang MS
Jpn Heart J 1992 Jan;33(1):49-59. doi: 10.1536/ihj.33.49. PMID: 1573779
Efficacy and tolerance of intravenous lorcainide in patients with normal and impaired intraventricular conduction.
Stroobandt R, Kesteloot H
Acta Cardiol 1985;40(6):637-48. PMID: 3879420

Diagnosis

Diversity of atrioventricular conduction in a female teenager.
Chen Q, Jing X
Ann Noninvasive Electrocardiol 2023 May;28(3):e13023. Epub 2022 Nov 30 doi: 10.1111/anec.13023. PMID: 36453000Free PMC Article
ECG of the Month. Unexpected Atrioventricular Conduction in High-Grade Atrioventricular Block. DIAGNOSIS: Sinus rhythm; high-grade second-degree atrioventricular block with a junctional escape rhythm and three capture complexes, each with right bundle branch block aberration; possible septal myocardial infarct of indeterminate age; ST-T and U wave changes suggesting hypokalemia.
Singh M, LeLorier PA, Celebi MM, Glancy DL
J La State Med Soc 2014 Mar-Apr;166(2):75-7. Epub 2014 Apr 10 PMID: 25075592
Arrhythmias in children.
Jat KR, Lodha R, Kabra SK
Indian J Pediatr 2011 Feb;78(2):211-8. Epub 2010 Oct 27 doi: 10.1007/s12098-010-0276-x. PMID: 20978872
Manifest and concealed AV nodal reentry in Wenckebach type of AV conduction with AV junctional escape rhythm.
Oreto G, Consolo A, Scimone IM
J Electrocardiol 1996 Oct;29(4):333-6. doi: 10.1016/s0022-0736(96)80098-7. PMID: 8913908
Atrioventricular junctional premature and escape beats with altered QRS and fusion.
Kistin AD
Circulation 1966 Nov;34(5):740-51. doi: 10.1161/01.cir.34.5.740. PMID: 4162581

Therapy

Temporary cardiac pacemaker in the treatment of junctional rhythm and hypotension due to imipramine intoxication.
Sert A, Aypar E, Odabas D, Aygul MU
Pediatr Cardiol 2011 Apr;32(4):521-4. Epub 2011 Feb 20 doi: 10.1007/s00246-011-9914-y. PMID: 21336976
Corrected QT interval prolongation after an overdose of escitalopram, morphine, oxycodone, zopiclone and benzodiazepines.
Baranchuk A, Simpson CS, Methot M, Gibson K, Strum D
Can J Cardiol 2008 Jul;24(7):e38-40. doi: 10.1016/s0828-282x(08)70643-3. PMID: 18612505Free PMC Article
Late occurrence of heart block after radiofrequency catheter ablation of the septal region: clinical follow-up and outcome.
Pelargonio G, Fogel RI, Knilans TK, Prystowsky EN
J Cardiovasc Electrophysiol 2001 Jan;12(1):56-60. doi: 10.1046/j.1540-8167.2001.00056.x. PMID: 11204085
A comparative study of a modified catheter-mediated direct current and radiofrequency ablation on atrioventricular junction.
Chen SA, Hsia CP, Tsang WP, Wang TC, Ting CT, Wang SP, Chiang BN, Kong CW, Chang MS
Jpn Heart J 1992 Jan;33(1):49-59. doi: 10.1536/ihj.33.49. PMID: 1573779
Efficacy and tolerance of intravenous lorcainide in patients with normal and impaired intraventricular conduction.
Stroobandt R, Kesteloot H
Acta Cardiol 1985;40(6):637-48. PMID: 3879420

Prognosis

Temporary cardiac pacemaker in the treatment of junctional rhythm and hypotension due to imipramine intoxication.
Sert A, Aypar E, Odabas D, Aygul MU
Pediatr Cardiol 2011 Apr;32(4):521-4. Epub 2011 Feb 20 doi: 10.1007/s00246-011-9914-y. PMID: 21336976
Late occurrence of heart block after radiofrequency catheter ablation of the septal region: clinical follow-up and outcome.
Pelargonio G, Fogel RI, Knilans TK, Prystowsky EN
J Cardiovasc Electrophysiol 2001 Jan;12(1):56-60. doi: 10.1046/j.1540-8167.2001.00056.x. PMID: 11204085

Clinical prediction guides

Apparent AV junctional escape in Wenckebach AV block: markedly slow conduction through the slow AV pathway.
Kinoshita S, Katoh T, Hagisawa K, Fukushima T, Ikawa S
J Cardiovasc Med (Hagerstown) 2009 Feb;10(2):161-6. doi: 10.2459/JCM.0b013e32831a6a0d. PMID: 19194175
Non-sinus bradyarrhythmias in very low birth weight infants.
Gamble YD, Lutin WP, Mathew OP
J Perinatol 2007 Jan;27(1):65-7. doi: 10.1038/sj.jp.7211623. PMID: 17180134
Advanced A-V block with apparent A-V junctional escape complexes because of dual A-V nodal pathways.
Luzza F, Carerj S, Oreto G
J Electrocardiol 2001 Oct;34(4):351-3. doi: 10.1054/jelc.2001.27847. PMID: 11590578
Late occurrence of heart block after radiofrequency catheter ablation of the septal region: clinical follow-up and outcome.
Pelargonio G, Fogel RI, Knilans TK, Prystowsky EN
J Cardiovasc Electrophysiol 2001 Jan;12(1):56-60. doi: 10.1046/j.1540-8167.2001.00056.x. PMID: 11204085
Demonstration of a widely distributed atrial pacemaker complex in the human heart.
Boineau JP, Canavan TE, Schuessler RB, Cain ME, Corr PB, Cox JL
Circulation 1988 Jun;77(6):1221-37. doi: 10.1161/01.cir.77.6.1221. PMID: 3370764

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