Junctional Ectopic Tachycardia Guidelines

Updated: Sep 13, 2016
  • Author: M Silvana Horenstein, MD; Chief Editor: Stuart Berger, MD  more...
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Guidelines Summary

In 2015 the American College of Cardiology, American Heart Association and the Heart Rhythm Society (ACC/AHA/HRS) released joint guidelines for the management of supraventricular tachycardia that includes recommendations for the management of junctional tachycardia. [17]  

Acute Junctional Tachycardia

Intravenous beta blockers, diltiazem, procainamide, or verapamil are all reasonable options. (Class IIa; Level of evidence: C-LD)

Treatment of nonparoxysmal junctional tachycardia due to digoxin toxicity or myocardial infarction is focused on addressing the underlying condition. In addition, there is some evidence that beta blockers, intravenous adenosine, or verapamil can terminate an accelerated junctional arrhythmia.

Ongoing Junctional Tachycardia

Treatment options include the following:

  • Oral beta blockers, diltiazem, or verapamil (Class IIa; Level of evidence: C-LD)
  • Flecainide or propafenone in patients without structural heart disease or ischemic heart disease (Class IIb; Level of evidence: C-LD)
  • Catheter ablation when medical therapy is not effective or contraindicated.  (Class IIb; Level of evidence: C-LD)