Accelerated Junctional rhythm

If your patient is hemodynamically stable, with no associated symptoms related to inadequate perfusion, an accelerated junctional rhythm doesn't require intervention. They will probably be following up with a cardiologist for the long term to ensure they do not develop other cardiac problems related to conduction dysfunction.

If they are on a negative chronotropic such as a beta blocker, they may be given time for it to wear off to see if sinus rhythm returns. Is there an atrial rhythm? If they are in atrial fib or atrial flutter, they may be given an anticoagulant because blood may pool in the left atrial appendage, put the patient at risk for a thrombotic CVA.

They may undergo testing for any structural heart disease: an echo to assess valve function, wall motion, and ejection fraction. They might also be assessed for myocardial perfusion to ascertain if the rhythm is due to infarction, and to see how the heart reacts to stress.

Many people may be asymptomatic, but they do lose atrial kick. I personally am in a junctional rhythm currently, at 44 beats a minute. I get dyspneic on exertion and tire easily. And my atria are in flutter, so I am on an anticoagulant.