AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, Switzerland, 25 - 28 May 2022, pp.491
BACKGROUND AND AIM: In this study, we aimed to evaluate the clinical features,
electrophysiological study, and ablation results of permanent junctional reciprocating tachycardia
(PJRT) in children.
METHODS: Twenty nine pediatric patients followed up with the diagnosis of PJRT in two pediatric
electrophysiology centers between 2011-2021 were included. The basic demographic characteristics
of the patients, electrocardiographic and echocardiographic findings were obtained retrospectively
from the file records. The medical treatment responses of the patients during the follow-up, the
electrophysiological study, and the ablation data of the patients who underwent electrophysiological
study were evaluated.
RESULTS: The mean age at diagnosis of the patients was 3.13±4.43(0-18) years and the mean weight
was 18.22±19.68kg (3.8-94). 62.1% of the patients were girls. At the time of admission, 11 patients
(37.9%) had tachycardia-induced cardiomyopathy (TIC) and their mean ejection fraction was
34±14%. In 15 (51.7%) patients, tachycardia was incessant and all patients except one received
medical treatment before ablation. 22 patients were using multidrug therapy (2 or more
antiarrhythmics). The most commonly used agents were amiodarone, beta-blockers, class 1 c drugs,
and their combinations. A total of 26 ablation procedures were required in 22 patients. The most
common indications for ablation were TİC and multidrug-resistant tachycardia. Accessory pathway
localization was right posteroseptal in 18 (81.81%) patients, the intracoronary sinus-middle cardiac
vein in 2 patients, midseptal in one patient, and posterior-posteroseptal oblique pathway in one
patient. The acute procedure success rate was 100%(22/22). The recurrence rate was 18% (4/22),
and three of them underwent successful ablation again. The overall success rate was %95.4 (21/22).
There were no complications in any of the patients. Cumulative success was 21/22 (95.4%). The
mean follow-up period was 4.39±3.05 years. The spontaneous resolution was observed in only 1 of
the 7 patients who were followed up clinically with antiarrhythmics, and 6 of the patients are still
under follow-up on medical therapy.
CONCLUSIONS: Although PJRT is rare, often incessant, resistant to medical treatment, and has a high
risk of developing TİC. In such patients, catheter ablation can be performed at any age with low
complication and high success rates. It is important to follow the patients in terms of recurrence.