Paroxysmal (or "focal") JT:
- Uncommon in pediatric populations and even less common in adults. It most often occurs in young adults in association with exercise or stress but may occur congenitally or postoperatively. It may be found in patients with structurally normal hearts or in patients with congenital cardiac abnormalities.
- Patients are often quite symptomatic and, if untreated, may develop heart failure, particularly if tachycardia is incessant.
- Usually responds to beta blockers or intravenous flecainide. Catheter ablation may be curative, although there is a 5%-10% risk of AV block.
- May occur in the setting of myocardial ischemia, cardiac surgery, myocarditis, hypokalemia, chronic obstructive lung disease with hypoxia, or digoxin toxicity, and is generally a benign condition.
- The mainstay of treatment is correction of the underlying abnormality. Persistent JT may be suppressed with beta blockers or calcium channel blockers.
I47.1 – Supraventricular tachycardia
419166005 – Junctional ectopic tachycardia