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.

Patient's can be asymptomatic for example, or experience difficulty breathing and chest pain if they have underlying congestive heart failure.

Other nonspecific findings include dizziness, fatigue, palpitations, and passing out.

[1][5] Anything that impairs the SA node can potentially lead to a junctional rhythm.

Junctional rhythms can present with either bradycardia, a normal heart rate, or tachycardia.

This is because of retrograde flow to the atria causing depolarization prior to the ventricular contraction.

Pacemaker Junctional rhythm is seen equally in men and women, and can be seen intermittently in young children and athletes, especially during sleep.