Successful treatment of accelerated junctional rhythm with propranolol: Possible role of sympathetic stimulation in the genesis of this rhythm disturbance

Accelerated junctional rhythms (ventricular rate >60 bpm) are common during general anesthesia. Little is known, however, about the etiology of this rhythm disturbance. We recently cared for a patient with multiple episodes of accelerated junctional rhythm in whom propranolol consistently resulted in conversion to sinus rhythm. The reproducible response of this patient to a beta-adrenergic receptor antagonist suggests that overactivity of the sympathetic nervous system often may be responsible for this rhythm disturbance.