Permanent junctional reciprocating tachycardia: an incessant tachycardia in children.

UNLABELLED: Permanent junctional reciprocating tachycardia is an infrequent form of reentrant supraventricular tachycardia but is the commonest incessant tachycardia in childhood. The persistent nature of the tachycardia can lead to heart failure secondary to left ventricular dysfunction and the arrhythmia is often refractory to drug control.

STUDY

OBJECTIVE

To review the main clinical features and therapeutic options currently available for this arrhythmia.

DESIGN

Retrospective study.

PATIENTS: A group of 5 children with a diagnosis of permanent junctional reciprocating tachycardia.

RESULTS

Age at presentation ranged between 14 days and 12 years. Three were asymptomatic. The first echocardiogram displayed left ventricular dilation and decreased shortening fraction in one child. Pharmacological therapy was initially successful in all. During follow-up (0.2-4.5 years) the arrhythmia became resistant to medication in one case and radiofrequency ablation was carried out.

CONCLUSIONS

Permanent junctional reciprocating tachycardia has a wide range of clinical presentations. Pharmacological therapy is recommended, but radiofrequency ablation is the definitive treatment and only depends on patient age.