Background: An accelerated junctional rhythm in the post-operative setting may be a precursor to the more aggressive Junctional Ectopic Tachycardia (JET). The AEG appears similar to JET but with a slower rate, usually within 15% of the rate of the sinus rhythm.
AEG: An accelerated junctional rhythm may show 1:1 atrial to ventricular signals or more ventricular than atrial signals depending on the retrograde AV nodal conduction. During this arrhythmia, with intact retrograde conduction, the atrial signal often closely follow the ventricular signals, similar to the VA timing seen with JET. The arrhythmia often has rate variability and gradual onset. When rates are close to the sinus rhythm, an accelerated junctional rhythm may intersperse with sinus rhythm.
Adenosine: It is not generally not responsive to adenosine.
Atrial Overdrive Pacing: Atrial pacing at a rate higher than the accelerated junctional rhythm suppresses the arrhythmia, which typically returns when pacing is discontinued.