Long-term Spontaneous Remission of Congenital Junctional Ectopic Tachycardia

Update on Pediatric non-Postoperative Junctional Ectopic Tachycardia.

“…Similar rates were observed in Sarubbi ´s work in which 44.4% presented heart failure and 66% ventricular systolic dysfunction [4]. In Maldonado et al, among 23 patients with congenital JET, 45.5 % had shortening fraction lower than 30%, and 62.5% were admitted into intensive care due to heart failure [5]. Some cases during fetal life have been reported.…”

“…The incidence of tachycardia-induced cardiomyopathy is very low. In our experience, we have 9 patients with late onset JET, and none of them has developed ventricular dysfunction [5]. There are reports of sporadic cases that can develop complete AV block over time [15,16].…”

“…There are some cases in which mechanism is triggered activity since, to be induced, the use of isoproterenol with atrial stimulation is required, and it can be reverted to sinus rhythm with adenosine administration [10]. In some patients, the existence of families with congenital JET suggests a genetic origin of the arrhythmia [2][3][4][5]. Xi et al reported a family of 6 members with progressive cardiac conduction defect; two of them also developed congenital JET.…”

“…In Maldonado et al, the average frequency was 192 bpm [2,3]. High heart rate during long periods of time, irregular rhythm, lack of AV synchrony and low contractile myocardial reserve favors the development of severe dilated cardiomyopathy and heart failure in newborns, sometimes leading to cardiogenic shock [2][3][4][5]. Villain et al reported an incidence of 61.5% with heart failure and shortening fraction reduction [2].…”

“…Development and advances in ablation techniques such as cryoablation and 3D mapping may cure JET with an acceptable rate of success and low complications. Some studies have demonstrated the existence of cases with spontaneous remission after long periods of treatment with antiarrhythmic drugs [4,5].…”