Permanent junctional reciprocating tachycardia (PJRT) is a rare form of nearly incessant supraventricular tachycardia occurring predominantly in infants and children and characterized by a long RP′ interval and, in the typical form, by negative P-waves in leads II, III, and aVF on the surface ECG. During sinus rhythm, the surface ECG is normal, without manifest pre-excitation. PJRT is caused by an atrioventricular (AV) re-entry using the AV node as the antegrade limb and a slowly conducting accessory pathway (AP) as the retrograde limb. The location of the AP is commonly right posteroseptal with an atrial insertion close to the ostium of the coronary sinus, but other locations have been reported. Chronic uncontrolled tachycardia has been reported to result in tachycardia-induced cardiomyopathy (TIC), which usually recovers with adequate ventricular rate control As PJRT is most of the time refractory to drug therapy, radiofrequency catheter ablation of the AP has become the treatment of first choice.

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www.inspire.com/conditions/permanent-junctional-reciprocating-tachycardia-pjrt