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Tex Heart Inst J. 2010;37(6):695-8.

Tachycardia-mediated cardiomyopathy and the permanent form of junctional reciprocating tachycardia.

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Department of Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.


Permanent junctional reciprocating tachycardia, or atrioventricular reentrant tachycardia utilizing a slowly conducting posteroseptal accessory pathway, is a rare form of reentrant supraventricular tachycardia in children and adults. The characteristic features of this narrow complex tachycardia are a long RP interval and inverted P waves in the inferior leads. This form of accessory-pathway-mediated tachycardia, which is usually incessant, can lead to a tachycardia-induced cardiomyopathy and congestive heart failure if left untreated. Radiofrequency ablation of the accessory pathway in permanent junctional reciprocating tachycardia is the definitive treatment in these patients, and in many instances the effects of prolonged tachycardia on ventricular function are reversible after successful ablation. We present an illustrative case.


Accessorypathway; cardiomyopathy, tachycardia-mediated; catheter ablation; electrocardiography; heart conduction system/abnormalities/physiopathology/surgery; tachycardia, atrioventricular nodal reentry; tachycardia, orthodromic reciprocating; tachycardia, permanent junctional reciprocating; tachycardia, supraventricular; tachycardia/diagnosis

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