Persistent Junctional Reciprocating Tachycardia

Dorostkar, Parvin C.

doi:10.1007/978-1-4939-2739-5_6

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“…This similarity in conduction characteristics to the AV node thereby creates a stable reentrant circuit and results in narrow complex tachycardia. It is also the reason for the persistence and refractoriness of SVT, which can lead to left ventricular dilatation and TIC . The heart rates in PJRT can range from 200 to 300 in infancy and later on decreases from 250 in early childhood to 120 in adults …”

Section: Introductionmentioning

confidence: 99%

“…The next step would be to determine the ratio of RP to PR interval. The EKG criteria for the diagnosis of PJRT include (Figure ), RP interval is longer than PR interval (because of the location and decremental conduction properties of the AP) 1:1 AV ratio (no dissociation) Inverted P wave are often visible in the inferior leads, II, III, and AVF Does not require a critically timed extrasystole for initiation Not associated with frequent PACs PR interval is never prolonged The rates are typically slightly slower than typical SVT (can be confused with sinus tachycardia) Response to vagal maneuvers with gradual slowing of the tachycardia because of prolongation of both RP and PR intervals and eventual termination but with recurrence shortly afterwards The AV conduction is usually sensitive to adenosine with tachycardia terminating with AV or VA block but again recurring shortly afterwards QRS is normal and narrow during sinus rhythm and in tachycardia …”

Section: Introductionmentioning

confidence: 99%

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Permanent junctional reciprocating tachycardia in infants and Children

Kylat

Samson

2019

Journal of Arrhythmia

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Permanent junctional reciprocating tachycardia ( PJRT ) is a rare form of supraventricular tachycardia ( SVT ). It generally presents in infants but can be difficult to diagnose. The characteristic EKG findings, response to Adenosine and persistence or frequent recurrences are helpful in making the diagnosis. It is usually difficult to manage with the initial and single medications used in SVT . Many patients are misdiagnosed and not treated effectively and end up having end stage cardiomyopathy and are diagnosed in patients referred for transplant. Hence all patients referred for a cardiac transplant with dilated cardiomyopathy need to be evaluated for this arrhythmia. If appropriate treatment is started early in the course, the failure can be ameliorated, and the cardiomyopathy can be resolved.

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Section: Introductionmentioning

confidence: 99%