Premature junctional complex

Background

WPW with PJC underlined in red

Less common than PVCs or PACs
Differentiate from WPW (short PR)
May be seen in healthy individuals with no clinical significance
- May also be seen in pathology such as valvular disease, drug toxicity, electrolyte abnormalities

Clinical Features

Generally asymptomatic
May cause palpitations

Differential Diagnosis

Palpitations

Arrhythmias:
Non-arrhythmic cardiac causes:
Psychiatric causes:
- Panic attack
- Anxiety
- Somatic Symptom Disorder
Drugs and Medications:
- Alcohol
- Caffeine
- Drugs of abuse (e.g. cocaine)
- Medications (e.g. digoxin, theophylline)
- Tobacco
Misc

Evaluation

EKG
- P wave is either: Absent, Abnormal with PR < 120ms, OR Retrograde, which may be inverted in inferior leads
- PJC arrives before next sinus beat
- Followed by compensatory pause
- From AV node region, with ventricular response usually normal, so QRS complexes usually narrow
- If conduction is abnormal, may have right bundle branch block morphology

Management

Depends on etiology and symptoms

Disposition

Based on etiology and symptoms

See Also

ECG (Main)

References

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