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  • Title: [Permanent junctional reciprocating tachycardia: a little-known clinical entity curable with radiofrequency ablation].
    Author: Menafoglio A, Schläpfer J, Kappenberger L, Fromer M.
    Journal: Schweiz Med Wochenschr; 1995 Oct 21; 125(42):1980-8. PubMed ID: 7481656.
    Abstract:
    We report our experience of 5 patients with the permanent form of junctional reciprocating tachycardia (PJRT), a rare form of supraventricular arrhythmia. PJRT was discovered at a mean age of 31 years (8-60 years) and the mean duration of tachycardia was 13 years (1-40 years). 4 patients had nearly incessant tachycardia and one had paroxysmal attacks. Heart rate varied between 100 and 190 beats/minute and the minimal heart rate was on average 114 beats/minute. Four patients had palpitations, 2 developed tachycardia-induced cardiomyopathy, reversible after control of the arrhythmia, and 4 had asymptomatic episodes of PJRT. ECG showed in all cases a narrow-complex tachycardia with inverted P waves in inferior leads and RP interval greater than PR. All patients presented a posteroseptal accessory pathway. 4 patients received different antiarrhythmic drugs with only partially effective results. Radiofrequency catheter ablation of the accessory pathway was performed in all patients and was successful in 4, who remained free of recurrence after a mean follow-up of 26.5 months (4-37 months). The procedure was partially successful in the 5th patient, who is now asymptomatic under sotalol. Radiofrequency catheter ablation is therefore the treatment of choice of PJRT, a rare arrhythmia which should nevertheless be known in order to treat the patient correctly and avoid progression to cardiac failure, which is not always completely reversible.
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