COEXISTENCE of PERMANENT JUNCTIONAL RECIPROCATING TACHYCARDIA with RHEUMATIC VALVULAR DISEASE; A CASE SUCESSFULLY TREATED with RADIOFREQUENCY ABLATION

A seventeen years old female had presented with palpitation. On the electrocardiography (ECG), long RP, narrow QRS tachycardia, inverted P waves in leads D2, D3 and aVF were noticed. On transthoracic echocardiography, rheumatic mitral valvular disease (RMVD) with normal ventricular systolic function was observed. Eccentric mitral regurgitation was also present. Electrophysiology study (EPS) was performed at our institution. According to EPS and surface ECG findings our diagnosis was permanent junctional reciprocating tachycardia (PJRT). Atrial activation appeared earliest and nearly ostium of the coronary sinus. The accessory pathway was detected near the coronary sinus ostium. RF ablation was performed, successfully. Tachycardia was terminated in three seconds. Permanent junctional reciprocating tachycardia can rarely coexist with RMVD. Here, we are reporting a case of PJRT and RMVD coexistence that underwent successful radiofrequency (RF) catheter ablation. This case report confirms that RF catheter ablation should be considered as the treatment of choice in adult patients with PJRT for the following reasons: catheter ablation is highly successful, the complication rate is low, and PJRT may lead to tachycardia induced cardiomyopathy, which is reversible.