I have a junctional rhythm.  Is my SA node working some, and will my AV node fail next?

SA node vs. AV node?

I’ve been dealing with rhythm issues for years now. While I been told in the past my junctional rhythm (accelerated JA) isn’t serious, I’ve read numerous times that this rhythm is “usually” found in people with heart disease. My blood work (done 2x a year) is always good, and CMRI and echo were normal in 2012.

To my understanding in layman’s terms, it seems like I have junctional rhythm because the SA node isn’t working properly, thus the AV node bears the responsibility of pacing now. Does that mean that the AV node will fail next? Does it also mean that the SA node doesn’t work at all, or just not some of the time?

As a footnote, I’ve never had pre-syncope or syncope, nor do I have BP issues (I’m 44 yrs old). And despite the junctional rhythm, I’ve not been hindered in doing anything. Actually, I generally only feel skips, palpitations when I check my pulse on my neck. In the immortal words of my EP, “you need to stop doing that” (checking my pulse).

Submitted by Rich from Pittsburgh on 11/11/2014

by Mohammad Saeed, MD

Accelerated junctional rhythm is a benign arrhythmia and in the absence of symptoms does not require any treatment. Presence of this rhythm does not imply that there is anything wrong with SA node and it will not lead to wearing down of AV node. Your EP doctor is correct in asking you to stop checking your pulse.