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J Arrhythmia. 2020; 36: 59-66.
Received: 07 August 2019 / Accepted: 11 November 2019
Junctional ectopic tachycardia in infants and children
Ranjit I Kylat, MD, Ricardo A Samson, MD
Ranjit I. Kylat, Division of Neonatal-Perinatal Medicine and Developmental Biology, Department of Pediatrics, University of Arizona, College of Medicine, PO BOX 245073, 1501 N Campbell Avenue, Tucson, AZ 85724. Email: firstname.lastname@example.org
Tachyarrhythmias originating in the atrioventricular (AV) node and AV junction including the bundle of His complex (BH) are called junctional tachycardia (JT) or junctional ectopic tachycardia (JET). Congenital JET (CJET) is a rare arrhythmia that occurs in patients without a preceding cardiac surgery and can be refractory to medical therapy and associated with high morbidity and mortality. CJET has a high rate of morbidity and mortality with death occurring in 35% of cases. JET occurring within 72 hours after cardiac surgery is referred to as postoperative JET (POJET) and caused by direct trauma, ischemic, or stretch injury to the AV conduction tissues during surgical repair of congenital heart defects. Focal junctional tachycardia (FJT) is also known as automatic junctional tachycardia and includes paroxysmal or non-paroxysmal forms. We discuss a staged approach to therapy with improved pharmacological therapies and the use of catheter-based therapies.