Junctional rhythm Junctional rhythm Junctional rhythm describes an abnormal heart rhythm resulting from impulses coming from a locus of tissue in the area of the atrioventricular node, the "junction" between atria and ventricles. Under normal conditions, the heart's sinoatrial node determines the rate by which the organ beats – in other words, it is the heart's "pacemaker". The electrical activity of sinus rhythm originates in the sinoatrial node and depolarizes the atria. Current then passes from the atria through the atrioventricular node and into the bundle of His, from which it travels along Purkinje fibers to reach and depolarize the ventricles. This
Sinoatrial node superior vena cava and the inferior vena cava. The cells of the SA node are spread out within a mesh of connective tissue, containing nerves, blood vessels, collagen and fat. Immediately surrounding the SA node cells are paranodal cells. These cells have structures intermediate between that of the SA node cells and the rest of the atrium. The connective tissue, along with the paranodal cells, insulate the SA node from the rest of the atrium, preventing the electrical activity of the atrial cells from affecting the SA node cells. The SA node cells are smaller and paler than the surrounding