Which medication is notorious for causing junctional arrhythmias?

The medication known for causing junctional arrhythmias is digoxin. Digoxin works by increasing the force of cardiac contractions and has effects on the electrical conduction system of the heart. Junctional arrhythmias can occur due to the enhanced vagal tone and attenuation of conduction through the atrioventricular (AV) node that digoxin often induces. This can lead to the heart's electrical impulses originating from the AV junction rather than the sinoatrial (SA) node, resulting in junctional rhythms.

Additionally, digoxin toxicity can exacerbate these effects, causing a higher likelihood of junctional escape rhythms or junctional bradycardia, particularly when digoxin levels in the body rise significantly. This characteristic makes digoxin notable among cardiovascular medications when considering junctional arrhythmias.