Junctional tachycardia
Also calledJT · focal junctional tachycardia
Definition
A junctional rhythm faster than 100 bpm that arises from enhanced (abnormal) automaticity in the AV junction, including the His bundle. It is a narrow-complex tachycardia that is occasionally irregular; retrograde P waves may be seen, and AV dissociation may be present. It is nonreentrant, which distinguishes it from AV nodal reentrant tachycardia (AVNRT). The 2015 ACC/AHA/HRS SVT guideline gives typical rates of 120 to 220 bpm and notes that it is uncommon in adults and typically seen in infants after surgery for congenital heart disease, where it is also known as junctional ectopic tachycardia (JET); a rare congenital form also occurs.
Clinical noteJunctional rhythms are conventionally named by rate: escape 40 to 60 bpm, accelerated 60 to 100 bpm, and tachycardia above 100 bpm. The boundaries are not sharp (the 2015 SVT guideline puts accelerated junctional rhythm at 70 to 130 bpm), and rates of 200 to 250 bpm are typical of the congenital form in infants.
Sources
- Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia. Circulation. 2016;133(14):e506-e574. doi.org/10.1161/CIR.0000000000000311
- Kylat RI, Samson RA. Junctional ectopic tachycardia in infants and children. J Arrhythm. 2020;36(1):59-66. doi.org/10.1002/joa3.12282
- Ashkanani AA, Ashkanani AH, Alkandari MF, et al. An accessible algorithm for the quick and precise interpretation of atrioventricular blocks in electrocardiograms. Ann Noninvasive Electrocardiol. 2026;31(4):e70207. doi.org/10.1111/anec.70207
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.