Junctional rhythms are cardiac rhythms originating from the atrioventricular (AV) junction, typically occurring when the sinoatrial (SA) node fails to initiate impulses. Clinically, they indicate an underlying issue with the heart's electrical conduction system, often seen in bradycardia or AV block. A key association is with digoxin toxicity, where junctional rhythms can emerge as a compensatory mechanism in response to altered conduction dynamics.