Background: PJCs are due to an early ventricular originating from the AV nodal area resulting in an early complex with a similar appearance to the baseline QRS. They are relatively uncommon after heart surgery.
AEG: PJCs have a similar appearance to the baseline QRS complex but are single and early without a proceeding atrial signal. Similar to PVCs, the A-V ratio in PJC’s may demonstrate more ventricular than atrial signals, or a 1:1 AV ratio. Frequently, a PJC may demonstrate an early ventricular beat, with no alteration in timing of the atrial signals as seen in the idealized example above.
Adenosine: Adenosine is not effective for treatment or diagnosis of PJCs.
Atrial Overdrive Pacing: Though atrial overdrive pacing is not recommended for the treatment of PJCs, PJCs may be less common when the heart rate is higher.