A junctional rhythm is a heart rhythm that originates from the atrioventricular (AV) junction — the area around the AV node — rather than from the heart's normal pacemaker, the sinoatrial node. It typically arises when the sinus node fails to fire properly or its signal is blocked, allowing the AV junction to take over as a backup pacemaker.

Junctional rhythms are usually slower than normal, often 40–60 beats per minute, and on an ECG they may show absent, inverted, or abnormally placed P waves. They can be well tolerated or may cause symptoms of low cardiac output. Treatment depends on the cause and the patient's stability, addressing factors such as medication effects or underlying conduction disease.

CPR Certification Labs provides hands-on, American Heart Association–aligned CPR, BLS, ACLS, and PALS certification training to help providers master these life-saving skills.