JET Tachycardia

[Blax]

My 12 year old son was just diagnosed with JET Tachycardia after an EP Study and attempted ablation procedure about a week ago.  He started having problems with a rapid heart beat about 8 months ago.  After 2 visits to the emergency room and 2 opinions by two different pediatric cardiologist/electrophysiologists, it was initially thought that he just had SVT, and that the ablation would correct it.  He was on 25 mg of Atenolol prior to the attempted ablation. The atenolol was stopped about a week prior to the procedure. The ablation did not work and the JET Tachycardia was diagnosed during the procedure.  He was placed on 200 mg of Flecainide while in the hospital and sent home with a holter monitor to record his heart rhythym after 24 hours of release from the hospital.  His physical activities has been restricted (he just started school - no PE or any physical activity until further notice).  I have been trying to do research on his condition and the type of medicine he is on.  His MD has suggested a pacemaker be installed if the medicine does not work.  My son is fairly large for his age.  I am worried about the long term side effects of this medicine, and whether their are other options to successfully treat his condition so that he can have a normal life and do things kids his age like to do.  He has not had any other prior surgeries/procedures and his heart is otherwise structurally okay.  Although it has only been a week since his discharge, he seems to be tolerating the medicine okay.  He has tachycardias that may last a few sections while on the medicine, but nothing like the attacks that sent him to the emergency room this summer. He has a followup appointment with his MD tomorrow.  However, I was wondering if anyone has treated this type of tachycardia before, and if their are other successful treatment options available to my son. Please advise.

[Blax]

Thank you both for your comments.  The doctor advised us today that my son EKG and AV block are back to normal.  He has recommended that we stay the course on the medicine for now.  He has another followup appointment in about a month.

Thanks again.  This is a wonderful forum.  

[Michael J. McWilliams, M.D.]

Junctional  ectopic tachycardia is a rare form of tachycardia.  The mechanism is either triggered or automatic, but appears to be related to and worsened by increased sympathetic tone -- in English that means that we don't understand the mechanism that well yet.  It appears to be worse with stress and exercise.

There are three options for therapy:
1. medical therapy -- this if first line therapy. Medical therapy with flecainide is a reasonable options.  There are other medications that can be tried as well like amiodarone and propafenone.
2. Ablation-- it is possible to ablate this without causing heart block and needing a pacemaker.  It is important to understand that if ablation is attempted, there is a relatively high risk of needing a pacemaker even in the very best hands.
3. Ablation and pacemaker therapy.

It sounds like your doctor is doing all the right things for this very rare cause of tachycardia.

I hope this helps.  I wish you and your family the best.

[heartofgld]

JET (Junctional Ectopic Tachycardia) is a very rare form of SVT. It sounds like your son's EP is doing the right thing by trying a course of antiarrhythmics before throwing in the pacemaker. I will be interested to see what the forum Dr says. I will say a prayer for your family! Keep us posted with his progress.

[wmac]

What is JET Tachycardia??? I have never heard of it.