Congenital Junctional Ectopic tachycardia (JET) is a rare SVT.We are reporting our experience in cryo ablation of JET with follow up to three years.
We performed cryo ablation for four children.Their median age 5.5 + 0.7 years and median weight 19.4 + 1.1 Kg. Two patients had dilated LV.The automaticity nature of the arrhythmia was documented and reentrant circuits were excluded.
We performed cryo-mapping (-30o C) for 30 seconds in each location prior to full cryo lesion (- 60 to –75o C) for 3-4 minutes if it shows potential success. CS pacing was performed during lesions to document intact AV conduction. Cessation or slowing by more than 20% of the JET was used as a marker for potential success.
The total procedural and fluoro time were 152 + 41 minutes and 18.8 + 15.3 minutes. All patients had acute procedural success and ended with sinus rhythm. One patient had slow Junctional rate 85/min with Isuprel sinus rhythm took over. The total cryo lesions were 6 + 3. All the lesions were around the area of compact AV node. Occasionally transient AV block was observed during the lesion that resolved few minutes after immediate cessation of cryo energy.
Echo at 6 months follow up showed return LV to normal function in the four. Three patients’ Holter after 3 years of ablation showing no recurrence of JET.
Cryo ablation can safely terminate and treat drug resistant congenital JET with good long term follow up and outcome.