[Junctional reciprocating tachycardia: clinical and electrophysiological characteristics, and the role of fulguration in 5 cases].

The permanent form is a variety of junctional reciprocating tachycardia that is refractory to medical treatment. The anterograde arm of the circuit is formed by the His Purkinje bundle and the retrograde conduction is through a slow conduction Accessory Atrioventricular Pathway. We report five patients with this type of arrhythmia, subjected to electrophysiological assessment. Their mean age was 37 years, all suffered from palpitations and several medical treatments had failed. During tachycardia, electrocardiogram had a negative P wave in inferior leads and RP interval was bigger than PR interval. Accessory Pathway were located in the right postero-septal region in three patients, in the left postero-septal region in one and in the left lateral in one. Specific bundle fulguration was successfully attempted in four patients, in whom arrhythmias did not recur without medical treatment.