From the Research
A premature junctional contraction (PJC) is an early heartbeat that originates from the atrioventricular (AV) junction rather than the heart's normal pacemaker, the sinoatrial (SA) node. This abnormal beat occurs when cells in the AV junction fire an impulse before the next normal heartbeat from the SA node can occur. On an ECG, PJCs appear as beats with absent or abnormal P waves (which may be inverted or occur after the QRS complex) and a normal QRS complex. PJCs are generally benign and often asymptomatic, though some people may feel palpitations, skipped beats, or a fluttering sensation in the chest. Most PJCs don't require treatment unless they cause significant symptoms or occur frequently. Common triggers include caffeine, alcohol, stress, fatigue, and certain medications. PJCs happen because the AV junction contains pacemaker cells that can spontaneously generate electrical impulses when stimulated or irritated, temporarily overriding the SA node's control. If PJCs become frequent or bothersome, reducing stimulants, managing stress, and treating any underlying heart conditions may help reduce their occurrence, as discussed in the context of premature ventricular complexes 1. Some studies have investigated the mechanisms and implications of premature complexes, including those arising from the atrioventricular junction, although the focus has often been on premature ventricular complexes 2, 3, 4. However, the principles of managing symptoms and reducing triggers can be applied to PJCs as well, prioritizing the reduction of morbidity, mortality, and improvement of quality of life. Key considerations in the management of PJCs include:
- Reducing stimulants and managing stress
- Treating any underlying heart conditions
- Monitoring for symptoms and frequency of PJCs
- Considering lifestyle modifications and medical treatment if necessary, as informed by studies on premature ventricular complexes 1.