A junctional rhythm is a heart rhythm problem that can make your heartbeat too slow or too fast. If you have a junctional rhythm, you may not have any symptoms. But sometimes, this condition can make you feel faint, weak or out of breath. If symptoms interfere with your daily life, your provider may recommend treatment to regulate your heartbeat.
A junctional rhythm is a type of arrhythmia (irregular heartbeat). If you have a junctional rhythm, your heart’s natural pacemaker, known as your sinoatrial (SA) node, isn’t working as it should.
Your SA node sends electrical signals that control your heartbeat. When you have a junctional rhythm, your SA node stops working or sends signals that are too slow or weak. Your heart responds by using one of your backup pacemakers instead. Your heart’s backup pacemakers keep your heart beating, but they might make your heartbeat slower or faster than normal.
Your heart has three pacemakers that send electrical impulses through your heart. These pacemakers normally work together every time your heart pumps, and they include your:
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All types of junctional rhythms occur when the SA node isn’t working correctly. But there are different ways your heartbeat may change when this happens.
A normal adult heartbeat is 60 to 100 beats per minute (BPM). Junctional rhythm can cause your heartbeat to be slower than normal (bradycardia), or faster than normal (tachycardia). Types of junctional rhythm include:
A junctional rhythm is less common than other arrhythmias like atrial fibrillation. It is often found in children or adults who have:
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During a normal heartbeat, your SA node sends a signal to the AV node, which travels to your bundle of His. This series of electrical signals causes all four chambers of your heart to contract (squeeze). As your whole heart contracts, it pumps blood out to your body.
When you have a junctional rhythm:
With only half of your heart contracting, your organs and tissues don’t get as much oxygen-rich blood. In mild cases of junctional rhythm, you may not feel any different. But in more severe cases, you may have symptoms like shortness of breath or fatigue.
A junctional rhythm usually isn’t life-threatening, but if you have symptoms that interfere with your daily life, you may need treatment.
If you have a junctional rhythm, you may not have any signs or symptoms. But some people with a junctional rhythm experience:
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Causes of a junctional rhythm include:
Your healthcare provider will ask you about your symptoms and do a physical examination. They may also check your vital signs, which include your blood pressure, heart rate and breathing rate. During your exam, tell your provider about your:
Your provider may perform an electrocardiogram (EKG) to check for a junctional rhythm or another type of arrhythmia. Your provider sticks electrodes (pads) on your chest, arms and legs that are connected to a special computer. This noninvasive test measures and records your heart’s rhythm.
Your EKG shows a series of lines with curves and waves that indicate how your heart is beating. If you have a junctional rhythm, a small wave called a “P wave” is either inverted (upside down) or missing on your EKG.
An EKG can often diagnose a junctional rhythm. But you may need further testing to check your heart health, such as:
If you don’t have other heart problems and you don’t have symptoms, you may not need treatment for a junctional rhythm. Your provider may recommend regular checkups and EKGs to monitor your heart health.
You may need treatment if your blood oxygen levels are too low or your symptoms bother you. Your treatment may include:
There is no guaranteed way to prevent this condition. Sometimes it happens without an obvious cause. To prevent a junctional rhythm from getting worse, see your provider regularly. At these visits, you and your provider can discuss:
Having heart surgery or a heart transplant may increase your risk of a junctional rhythm. But once your heart has healed after surgery, the junctional rhythm may go away. Having another heart condition, especially another type of arrhythmia, also puts you at a higher risk of having a junctional rhythm.
A junctional rhythm usually doesn’t cause serious health problems and may go away with treatment. Even though there is no cure for a junctional rhythm, your provider can help you manage your symptoms. Managing any symptoms and getting treatment can help you feel your best.
You can live a healthy life with a junctional rhythm if you:
See your provider if you notice:
A note from Cleveland Clinic
Many people can manage a junctional rhythm with regular visits to their healthcare provider. But if you need treatment, medications or a pacemaker can often relieve your symptoms. A junctional rhythm doesn’t have to stop you from doing things you love. With regular medical care, many people live full, healthy lives with a junctional rhythm.
Last reviewed on 05/20/2022.
Learn more about the Health Library and our editorial process.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy