Conclusion
Persistent junctional reciprocating tachycardia is an arrhythmia that usually presents in infancy or childhood but may not be recognized until adulthood. In older patients, the heart rate may not be sufficiently fast to result in enough symptoms to provoke further examination or evaluation by a physician. Age-related changes in both the rate and the intermittent nature of the tachycardia may mask the diagnosis. Thus, the diagnosis may be delayed until tachycardia-related symptoms or palpitations become more apparent. Presentation with heart failure is more common in younger patients. Since the heart rates associated with PJRT will most likely slow with age, radiofrequency ablation may usually be deferred in small children with this tachycardia. Because the tachycardia has a possible spontaneous or intermittent resolution, as well as variable expression of impaired ventricular function, and since it may be effectively and safely treated with ablation, this definitive therapy, whether radiofrequency current or cryotherapy, should be considered only in patients of suitable size and when there are symptoms related to the tachycardia.
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Coumel P, Cabrol C, Fabiato A, et al. Tachycardie permanent par rhythm reciproque. Arch Mal Coeur 1967;60:1830–1864.
Scaglione M, Caponi D, Riccardi R, et al. Accessory pathway potential recording in a case of permanent junctional reciprocating tachycardia with decremental conduction localized on the atrial site. Ital Heart J 2001;2:147–151.
Haissaguerre M, Montserrat P, Warin JF, et al. Catheter ablation of left posteroseptal accessory pathways and of long RP’ tachycardias with a right endocardial approach. Eur Heart J 1991;12:845–859.
Monda V, Scherillo M, Critelli G. Closed chest catheter ablation of an accessory pathway in a patient with permanent junctional reciprocating tachycardia. J Am Coll Cardiol 1986;8:740.
Perry JC, Garson A, Jr. Complexities of junctional tachycardias. J Cardiovasc Electrophysiol 1993;4:224–238.
Perticone F, Marsico SA. Familial case of permanent form of junctional reciprocating tachycardia: possible role of the HLA system. Clin Cardiol 1988;11:345–348.
Medeiros CM, Lucchese FA. Permanent form of junctional reciprocating tachycardia with only even-numbered beats. J Electrocardiol 1989;22:249–256.
Critelli G. Permanent junctional reciprocating tachycardia. Pacing Clin Electrophysiol 1996;19:256–257.
Mantovan R, Viani S, Stritoni P. [Permanent junctional reciprocating tachycardia (Coumel type): an unusual location of a retrograde accessory pathway]. G Ital Cardiol 1999;29:315–320.
Klein GJ, Kostuk WJ, Ko P, Gulamhusein S. Permanent junctional reciprocating tachycardia in an asymptomatic adult: further evidence for an accessory ventriculoatrial nodal structure. Am Heart J 1981;102:282–286.
McGuire MA, Lau KC, Davis LM, et al. Permanent junctional reciprocating tachycardia misdiagnosed as ‘cardiomyopathy’. Aust N Z J Med 1991;21:239–241.
Critelli G. Recognizing and managing permanent junctional reciprocating tachycardia in the catheter ablation era. J Cardiovasc Electrophysiol 1997;8:226–236.
Zalzstein E, Zucker N, Sofer S, et al. Successful radiofrequency ablation in a 3-month-old baby with permanent junctional reciprocating tachycardia: a new era in the treatment of incessant life-threatening arrhythmias in infants. Am J Perinatol 1995;12:82–83.
Arribas F, Lopez-Gil M, Nunez A, Cosio FG. Wolff-Parkinson-White syndrome presenting as the permanent form of junctional reciprocating tachycardia. J Cardiovasc Electrophysiol 1995;6:132–136.
Gaita F, Haissaguerre M, Giustetto C, et al. Catheter ablation of permanent junctional reciprocating tachycardia with radiofrequency current. J Am Coll Cardiol 1995;25:648–654.
Dorostkar PC, Silka MJ, Morady F, Dick M, 2nd. Clinical course of persistent junctional reciprocating tachycardia. J Am Coll Cardiol 1999;33:366–375.
Chien WW, Cohen TJ, Lee MA, et al. Electrophysiological findings and long-term follow-up of patients with the permanent form of junctional reciprocating tachycardia treated by catheter ablation. Circulation 1992;85:1329–1336.
Jaeggi E, Fouron JC, Fournier A, et al. Ventriculoatrial time interval measured on M-mode echocardiography: a determining element in diagnosis, treatment, and prognosis of fetal supraventricular tachycardia. Heart 1998;79:582–587.
Coumel P. Junctional reciprocating tachycardias. The permanent and paroxysmal forms of A-V nodal reciprocating tachycardias. J Electrocardiol 1975;8:79–90.
Josephson ME SS. Preexcitation Syndrome, in: Clinical Cardiac Electrophysiology: Techniques and Interpretations. Lea & Febiger: Philadelphia, 1979.
Bartolome FB, Sanchez Fernandez-Bernal C, Torres Feced V. Anterograde decremental conduction by left free wall accessory pathway in the permanent form of junctional reciprocating tachycardia. Rev Esp Cardiol 2000;53:878–880.
Yagi T, Ito M, Odakura H, Namekawa A, et al. Electrophysiologic comparison between incessant and paroxysmal tachycardia in patients with permanent form of junctional reciprocating tachycardia. Am J Cardiol 1996;78:697–700.
Giani P, Maggioni AP, Volpi A, et al. Blood levels and electrophysiological effects of intravenous amiodarone in patients with junctional reciprocating tachycardia. Preliminary observations. Acta Cardiol 1984;39:9–17.
Chen RP, Ignaszewski AP, Robertson MA. Successful treatment of supraventricular tachycardiainduced cardiomyopathy with amiodarone: case report and review of literature. Can J Cardiol 1995;11:918–922.
Drago F, Silvetti MS, Mazza A, et al. Permanent junctional reciprocating tachycardia in infants and children: effectiveness of medical and non-medical treatment. Ital Heart J 2001;2:456–461.
Elbaz M, Fourcade J, Carrie D, et al. Atrial insertion of accessory pathways in permanent reciprocating junctional tachycardia. Arch Mal Coeur Vaiss 1995;88:1399–1405.
Jaeggi E, Lau KC, Cooper SG. Successful radiofrequency ablation in an infant with drug-resistant permanent junctional reciprocating tachycardia. Cardiol Young 1999;9:621–623.
Aguinaga L, Primo J, Anguera I, et al. Long-term follow-up in patients with the permanent form of junctional reciprocating tachycardia treated with radiofrequency ablation. Pacing Clin Electrophysiol 1998;21:2073–2078.
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Dorostkar, P.C. (2006). Persistent Junctional Reciprocating Tachycardia. In: Dick, M. (eds) Clinical Cardiac Electrophysiology in the Young. Developments in Cardiovascular Medicine, vol 257. Springer, Boston, MA. https://doi.org/10.1007/0-387-29170-9_6
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