PJRT

Long RP tachycardias are a unique collection of arrhythmias that include atypical (fast-slow) atrio-ventricular nodal reentrant tachycardia (AVNRT) with and without a concealed, bystander nodo-fascicular/ventricular accessory pathway (AP), orthodromic reciprocating tachycardia (ORT) using a concealed, slowly conducting, and decremental atrio-ventricular (AV) AP (PJRT), ORT using a concealed nodo-fascicular/ventricular AP (NFRT), and atrial tachycardia (AT)-all but the last being dependent upon the AV node. These tachycardias respond differently to pacing maneuvers than their short RP counterparts and can manifest: (1) both true and pseudo-AAV responses, (2) long uncorrected and corrected post-pacing intervals, (3) prolonged delta ventriculo-atrial (∆VA) and delta His bundle-atrial (∆HA) values, and (4) resetting with delay...

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...

A 5-year-old male English Bulldog was presented with a 1-year history of paroxysmal supraventricular tachycardia (SVT) partially responsive to amiodarone. At admission the surface ECG showed sustained runs of a narrow QRS complex tachycardia, with a ventricular cycle length (R-R interval) of 260 ms, alternating with periods of sinus rhythm. Endocardial mapping identified the electrogenic mechanism of the SVT as a circus movement tachycardia with retrograde and decremental conduction along a concealed postero-septal atrioventricular pathway (AP) and anterograde conduction along the atrioventricular node...

We present a case of 8 year-old boy with several episodes of ventricular fibrillation in the course of tachycardia-mediated cardiomyopathy and severe decompensated heart failure. The cardiomyopathy was caused by incessant long-RP tachycardia that was resistant to pharmacotherapy. Despite initial suspition that the arrhythmia was permanent junctional reciprocating tachycardia (PJRT) electrophysiology study revealed atypical atrioventricular nodal reentrant tachycardia. Due to clinical and electrocardiographical presentation mimicking PJRT such arrhythmia merits the name 'pseudo PJRT'...

A 52-year-old woman presented with left ventricular (LV) dysfunction and incessant narrow complex tachycardia. Electrocardiogram and clinical picture were suggestive of a permanent form of junctional reciprocating tachycardia, but electrophysiology study showed the tachycardia to be a fast-slow form of atrioventricular nodal reentrant tachycardia (AVNRT). Slow pathway ablation terminated the tachycardia and the LV dysfunction resolved completely at follow-up. Fast-slow AVNRT has not been reported to present in incessant form, and the mechanism in this patient was absent retrograde fast pathway conduction resulting in easy initiation and maintenance of tachycardia...

We reported a case of a child with neurodevelopment delay induced by long-term amiodarone exposure due to a treatment of fetal supraventricular tachycardia (FSVT), subtype permanent junctional reciprocating tachycardia (PJRT) with the normal thyroidal function. Refractory persistent FSVT was treated intrautero with digoxin (0.5 mg QD) until delivery and amiodarone (100 mg QD) from 26 to 35 weeks of gestation. A baby weighing 3550 g with normal acid-base status was delivered at 38 weeks of gestation. The PJRT recurred 28 hours after delivery and reverted to sinus rhythm with amiodarone and propranolol for another 24 months...

Ultrasound examination of a fetus at 32 weeks' gestation revealed dilated cardiomyopathy and a heart rate of 170 beats per minute. Prenatally, this mild tachycardia was not primarily suspected to be the cause of the myocardial changes. Postnatal electrocardiography revealed a persistent junctional reciprocating tachycardia (PJRT) and the diagnosis of tachycardia-induced cardiomyopathy (TICM) became apparent. After conversion to a sinus rhythm under digoxin and amiodarone, the cardiac changes regressed. PJRT is a rare form of supraventricular tachycardia...

A 25-year-old woman with drug-refractory permanent junctional reciprocating tachycardia (PJRT) and a previous failed ablation, was referred to our institution. Electrophysiological study confirmed the diagnosis of orthodromic atrioventricular reentry tachycardia using a slowly conducting accessory pathway. This accessory pathway was successfully ablated by conventional radiofrequency at the left anteroseptal region using a transseptal approach. Catheter ablation of this accessory pathway (Coumel type) at the mitral annulus-aorta junction offers insights on a rare anatomical location of PJRT...

We present 14-year-old girl with permanent junctional reciprocating tachycardia which was refractory to medicamentous therapy, who also had dilated cardiomyopathy. She underwent successful radiofrequent catheter ablation of accessory pathway after wich the histologic changes in the myocardium were observed in the form of compensatory hypertrophy of cardiac muscle (cardiac remodelling). The question of cause and consequence appeared: whether the arrhythmia is a consequence of dilated cardiomyopathy, or it is tachycardia- induced cardiomyopathy...

Transesophageal electrophysiologic study (TEEPS) is a semi-invasive method of atrial stimulation and recording. The aim of the study was to report our experience with TEEPS in children and young adults. A total of 153 TEEPS were performed in 147 consecutive patients aged between 26 days to 26 years (mean 9.8 years) with the following indications: evaluation of symptoms that may be signs of any arrhythmias in 89 procedures (Group A), risk assessment of Wolff-Parkinson-White syndrome (WPW) in 17 procedures (Group B), determination of the mechanism of previously detected or ongoing tachycardia on ECG or Holter monitoring in 22 procedures (Group C), assessment of antiarrhythmic therapy effectiveness in 17 procedures (Group D), and follow-up of radiofrequency ablation procedure (RFA) in 8 procedures (Group E)...

BACKGROUND: Mapping and catheter ablation of permanent junctional reciprocating tachycardia (PJRT) in children can be challenging. Remote magnetic navigation may improve precise mapping and catheter stability during ablation, as well as reduce fluoroscopy time, especially in conjunction with a non-fluoroscopic mapping system. OBJECTIVE: We report a case of PJRT ablation in a 7-year-old child using remote magnetic navigation. METHODS AND RESULTS: Mapping of the right atrium (RA) and the coronary sinus (CS) and catheter ablation were performed using remote magnetic navigation in conjunction with a non-fluoroscopic mapping system (NavX)...

OBJECTIVE: Cryoenergy is a new valuable treatment option to perform ablation close to the atrioventricular (AV) node in the cure of supraventricular tachycardias because of its favourable properties, such as the possibility of creating reversible lesions. The aim of this study was to report our experience on the effectiveness and safety of catheter cryoablation performed in "critical areas" to treat a large cohort of patients with supraventricular arrhythmias. METHODS: One hundred and thirty-one patients suffering from supraventricular tachycardias underwent catheter cryoablation using a 7F catheter...

BACKGROUND: Atrioventricular nodal reentry tachycardia is a supraventricular tachycardia with a double nodal pathway between the atria and the ventricles located in the normal AV-node. It may cause a reentry circuit. Atrioventricular nodal reentry tachycardia is one of the most common supraventricular tachycardias in adulthood, but is seldom diagnosed in children--perhaps because of difficulties with diagnosing them. We have studied diagnostic criteria, clinical presentation, incidence, prognosis and treatment in children and adolescents...

UNLABELLED: Electrophysiologic study (EPS) frequently is required to assess the prognosis of asymptomatic Wolff-Parkinson-White syndrome (WPW) or to prove the nature of no documented tachycardia. EPS usually is performed by intracardiac route and hospitalization is required. Similar data are given by an EPS performed by oesophageal route during a consultation. The purpose of the study was to evaluate the cost of both techniques in France. Transesophageal EPS was performed during a consultation in 100 patients with asymptomatic WPW syndrome and 100 patients with no heart disease, complaining of no documented tachycardias with abrupt beginning and end, suggesting a paroxysmal junctional re-entrant tachycardia (PJRT)...

Permanent form of junctional reciprocating tachycardia (PJRT) is an uncommon form of atrioventricular re-entrant tachycardia due to an accessory pathway characterized by slow and decremental retrograde conduction. The majority of accessory pathways in PJRT are localized in the posteroseptal zone. Despite the high success rate, failure may occur during endocardial radiofrequency catheter ablation due to epicardial insertion of the accessory pathway. We report a case of PJRT in a 25-year-old man in whom the accessory pathway was located epicardially in the posteroinferior region and ablated from within the middle cardiac vein by radiofrequency catheter ablation...

AIM: PJRT occurs predominantly in infants and children and is limited to small series in adults. The aim of this study was to describe the clinical presentation, electrophysiological characteristics, feasibility and safety of radiofrequency ablation, and the long-term prognosis in a large group of adult patients with the permanent form of junctional reciprocating tachycardia (PJRT). METHODS AND RESULTS: Forty-nine adult patients (22 male and 27 female; mean age 43+/-16) with a diagnosis of PJRT confirmed at electrophysiological study were included...

OBJECTIVES: To investigate the clinical profile, natural history, and optimal management of persistent or permanent junctional reciprocating tachycardia (PJRT) in children. METHODS AND RESULTS: 85 patients meeting the ECG criteria for PJRT were enrolled in a retrospective multicentre study. Age at diagnosis varied from birth to 20 years (median 3 months). Follow up ranged from 0.1 to 26.0 (median 8.2) years. At the time of referral, 24 of 85 patients (28%) had congestive heart failure that was resolved with medical treatment in all patients...

We intend to review our experience with the investigation and management of foetal arrhythmia on the basis of superior vena cava/ascending aorta (SVC/AA) Doppler flow velocity recordings. Irregular rhythms n = 307. Premature atrial and ventricular contractions were easily identified and generally self-limited in time. Sustained bradycardia n = 19. Four had sinus bradycardia, six presented with blocked atrial bigeminism, three showed 2:1, and five had a complete atrio-ventricular (AV) block. Another foetus that presented with first-degree AV block developed a Luciani-Wenckebach phenomenon 1 week later...

INTRODUCTION: Permanent junctional reciprocating tachycardia (PJRT) is an infrequent form of reciprocating tachycardia, almost incessant from childhood and usually refractory to drug therapy. Radiofrequency catheter ablation currently is the first-line therapy for PJRT, but its application in the septal region may be associated with complications. In contrast, cryoenergy has several advantages, such as the ability to test the effects of ablation while the lesion is still forming, thus reducing the number of ineffective, useless, and potentially harmful lesions...

The permanent form of junctional reciprocating tachycardia (PJRT) is usually refractory to drug therapy, and these patients are at risk of developing tachycardia-induced cardiomyopathy. The electrocardiogram insribes inverted P waves in leads 2, 3, aVF as well as left lateral leads, along with a P-R interval shorter than R-P interval during the tachycardia. This report describes a three-year-old male patient with PJRT who underwent successful radiofrequency catheter ablation (RFA) of accessory pathway. On transthoracic echocardiography of patient, decreased ventricular systolic function was observed...