Permanent junctional reciprocating tachycardia in children: a multicenter experience

Heart Rhythm. 2014 Aug;11(8):1426-32. doi: 10.1016/j.hrthm.2014.04.033. Epub 2014 Apr 24.


Background: Permanent junctional reciprocating tachycardia (PJRT) is an uncommon form of supraventricular tachycardia in children. Treatment of this arrhythmia has been considered difficult because of a high medication failure rate and risk of cardiomyopathy. Outcomes in the current era of interventional treatment with catheter ablation have not been published.

Objective: To describe the presentation and clinical course of PJRT in children.

Methods: This is a retrospective review of 194 pediatric patients with PJRT managed at 11 institutions between January 2000 and December 2010.

Results: The median age at diagnosis was 3.2 months, including 110 infants (57%; aged <1 year). PJRT was incessant in 47%. The ratio of RP interval to cycle length was higher with incessant than with nonincessant tachycardia. Tachycardia-induced cardiomyopathy was observed in 18%. Antiarrhythmic medications were used for initial management in 76%, while catheter ablation was used initially in only 10%. Medications achieved complete resolution in 23% with clinical benefit in an additional 47%. Overall, 140 patients underwent 175 catheter ablation procedures with a success rate of 90%. There were complications in 9% with no major complications reported. Patients were followed for a median of 45.1 months. Regardless of treatment modality, normal sinus rhythm was present in 90% at last follow-up. Spontaneous resolution occurred in 12% of the patients.

Conclusion: PJRT in children is frequently incessant at the time of diagnosis and may be associated with tachycardia-induced cardiomyopathy. Antiarrhythmic medications result in complete control in few patients. Catheter ablation is effective, and serious complications are rare.

Keywords: Antiarrhythmic medications ok; Catheter ablation; Pediatrics; Permanent junctional reciprocating tachycardia.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Electrocardiography*
  • Female
  • Follow-Up Studies
  • Heart Conduction System / physiopathology*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Tachycardia, Reciprocating / epidemiology
  • Tachycardia, Reciprocating / physiopathology*
  • United States / epidemiology