Open AccessAutomatic junctional tachycardia in an adult
Author(s) -
Kumagai K.,
Yamato H.,
Yamanouchi Y.,
Matsuo K.,
Tashiro N.,
Hiroki T.,
Arakawa K.
Publication year - 1990
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960131112
Subject(s) - medicine , tachycardia , cardiology , orthodromic , junctional rhythm , electrocardiography , verapamil , heart rate , reentry , ventricular tachycardia , qrs complex , electrophysiology , anesthesia , blood pressure , calcium
We report an adult patient with junctional ectopic tachycardia, a condition which was initially described in infants, frequently in association with congenital defects. The patient had a rapid, irregular paroxysmal junctional tachycardia with a rate ranging from 160 to 220 beats/min, distinguishing it from the more common nonparoxysmal junctional tachycardia in which a slower heart rate is seen. The electrophysiological study performed during an episode of tachycardia demonstrated periods of atrioventricular dissociation and narrow QRS complexes as well as a junctional ectopic rhythm, which was suggested by a His deflection preceding each ventricular depolarization with a normal HV interval. Both the response to exercise and the results of atrial and ventricular stimulation suggested enhanced automaticity of a high junctional focus. Therapy combining procainamide, verapamil, and digitalis proved to be effective. Thus, junctional ectopic tachycardia can also occur in adults, probably due to enhancement of automaticity.