Treatment

1. Isolated, infrequent junctional escape beats usually do not require specific treatment.

2. If sustained junctional escape rhythms are producing symptoms, the underlying cause should be treated. Atropine can be used to accelerate the sinus node discharge rate temporarily and enhance AV nodal conduction.

3. Accelerated junctional rhythm and junctional tachycardia usually do not produce significant symptoms. If the cause is digoxin toxicity, the drug should be discontinued. If the rate is fast and producing symptoms, giving supplemental potassium to increase the serum level into the high-normal range may decrease it.

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