Conditions that cause an increase of the impulse formation in the AV node (eg digitalis toxicity, ischemia) may result in an accelerated junctional rhythm. The ventricles are activated from the junction. The atria may be activated retrogradely, or have an independent rhythm (AV dissociation) Rate >60/min. (usually 70-130/mim). The QRS complexes are similar to those generated by atrio-ventricular conduction.
An accelerated junctional rhythm in a patient in atrial fibrillation suggests the presence of digitalis toxicity.
