Introduction
Persistent junctional reciprocating tachycardia (PJRT) is a rare form of
refractory supraventricular tachycardia (SVT) occurring in infants and
children and accounts for about 1% of all SVTs in this
group.1 Because of its incessant nature, if left
untreated, it may lead to tachycardia induced cardiomyopathy. The
circuit is PJRT is an orthodromic AV reentry with a concealed slow
conducting accessory pathway as the retrograde limb of the
circuit.2-5As both limbs in a PJRT circuit are
decremental, these tachycardias tend to typically occur at lower heart
rates than other SVTs and can be undetected until patients present with
heart failure. ECGs during SVT typically show negative P waves in the
inferior leads with a long RP interval.2,3
Here, we report on the case of a 3 month old infant who developed a
tachycardia induced cardiomyopathy and was successfully treated with
radiofrequency ablation (RFA). To our knowledge this is the youngest
reported patient with a successful epicardial lesion placed in the
diverticulum off the coronary sinus (CS).