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Junctional rhythm

Junctional rhythm is an abnormal heart rhyth, where the the HIS bundle initiates electrical activity in the heart. This causes the atria and ventricles to be electrically activated at the same time.

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In contrast, in normal conditions, sinus rhythm initiates in the Sinus node and activates the atria then progresses into the HIS bundle, down the Purkinje fibers and up the ventrical. This causes the atria to contract before the ventricals.

v • d • e Anatomy of torso, cardiovascular system: heart
Structures	atria (interatrial septum, musculi pectinati) • ventricles (interventricular septum, trabeculae carneae, chordae tendinae, papillary muscle) • valves • cusps
Regions	base • apex • grooves (coronary/atrioventricular, interatrial, anterior interventricula, posterior interventricular) • surfaces (sternocostal, diaphragmatic) • borders (right, left)
Right heart	(vena cavae, coronary sinus) → right atrium (auricle, fossa ovalis, limbus of fossa ovalis, crista terminalis, valve of the inferior vena cava, valve of the coronary sinus) → tricuspid valve → right ventricle (conus arteriosus, moderator band/septomarginal trabecula) → pulmonary valve → (pulmonary artery and pulmonary circulation)
Left heart	(pulmonary veins) → left atrium (auricle) → mitral valve → left ventricle → aortic valve (aortic sinus) → (aorta and systemic circulation)
Layers	pericardium: fibrous pericardium • serous pericardium (pericardial cavity, epicardium/visceral layer) • pericardial sinus myocardium • endocardium • cardiac skeleton (fibrous trigone, fibrous rings)
Conduction system	Cardiac pacemaker • SA node • AV node• bundle of His • Purkinje fibers