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Diagnosis and management of junctional ectopic tachycardia in children


1 Department of Pediatric Cardiology and Adult Congenital Heart Disease, Meditrina Hospital, Ayathil, Kollam, Kerala, India
2 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
3 Department of Pediatrics (Cardiology), Oregon Health and Science University, Portland, Oregon, USA

Correspondence Address:
Dr. Navaneetha Sasikumar
Consultant in Pediatric Cardiology, Adult Congenital Heart Disease, Downtown Hospital, GS Road, Dispur, Guwahati, 781006, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_35_21

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Year : 2021  |  Volume : 14  |  Issue : 3  |  Page : 372-381

 

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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.






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1 Department of Pediatric Cardiology and Adult Congenital Heart Disease, Meditrina Hospital, Ayathil, Kollam, Kerala, India
2 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
3 Department of Pediatrics (Cardiology), Oregon Health and Science University, Portland, Oregon, USA

Correspondence Address:
Dr. Navaneetha Sasikumar
Consultant in Pediatric Cardiology, Adult Congenital Heart Disease, Downtown Hospital, GS Road, Dispur, Guwahati, 781006, Assam
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_35_21

Rights and Permissions

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.






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