Permanent junctional reciprocating tachycardia

Abstract

The term permanent junctional reciprocating tachycardia (PJRT) describes an orthodromic atrioventricular reentry tachycardia using a usually concealed slowly conducting accessory pathway with decremental properties as the retrograde limb. The accessory pathway is most commonly located in the posteroseptal region; however, other locations have been described. PJRT is a rare form of supraventricular tachycardia and can be found in all age groups but the majority of affected patients are children and young adults. The 12-lead electrocardiogram during PJRT shows negative P waves in the inferior lead II, III, and aVF, with a long RP interval. Atypical atrioventricular nodal reentry tachycardia and focal atrial tachycardia are important differential diagnoses. Due to the often incessant nature of PJRT, patients may be at risk for tachycardia-induced cardiomyopathy. Whereas pharmacological treatment is often only moderately effective, catheter ablation of the accessory pathway is highly effective with a low complication rate.