Diagnosis and management of junctional ectopic tachycardia in children

• Published in: Annals of pediatric cardiology Vol. 14; no. 3; pp. 372 - 381
• Main Authors: Sasikumar, Navaneetha, Kumar, Raman, Balaji, Seshadri
• Format: Journal Article
• Language: English
• Published: Mumbai Wolters Kluwer India Pvt. Ltd 01.07.2021; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Cardiac arrhythmia; Congenital heart disease; congenital junctional ectopic tachycardia; Diagnosis; Diseases; Genetic aspects; Health aspects; Ivabradine; junctional ectopic tachycardia; Mortality; pediatric cardiopulmonary bypass; postoperative arrhythmia; postoperative complications; Procainamide; Review; Strategic planning (Business); Tachycardia; postoperative complications; Congenital junctional ectopic tachycardia; junctional ectopic tachycardia; pediatric cardiopulmonary bypass; postoperative arrhythmia
• ISSN: 0974-2069; 0974-5149
• DOI: 10.4103/apc.apc_35_21

Junctional ectopic tachycardia (JET) is more common in its postoperative form. A thorough understanding of its etiology, pathophysiology, and management strategies is essential. Classically, postoperative JET is considered to arise from surgical trauma. Genetic susceptibility and an intrinsic morphologic/functional defect in the conduction system inherent in congenital heart diseases likely play a significant role. The devastating effects on postoperative hemodynamics warrant prompt attention. A multipronged management approach with general measures, pharmacotherapy, and pacing has decreased morbidity and mortality. Amiodarone and procainamide remain the preferred drugs, while ivabradine appears promising. Carefully planned randomized trials can go a long way in developing a systematic management protocol for postoperative JET.