Junctional Ectopic Tachycardia After Adult Cardiac Surgery

Junctional ectopic tachycardia (JET) is a well-recognized postoperative arrhythmia in pediatric patients but is rarely described in adults following cardiac surgery.

A 31-year-old man developed acute dyspnea and palpitations on postoperative day 4 following aortic valve replacement and ascending aorta replacement. Telemetry revealed sustained narrow-complex tachycardia with atrioventricular dissociation, ventricular predominance (V > A), and QRS morphology identical to sinus rhythm. Other causes of postoperative tachycardia were systematically excluded, and JET was diagnosed. Conservative management resulted in spontaneous resolution of the arrhythmia.

JET is an uncommon but important cause of postoperative tachycardia in adults. This case emphasizes the diagnostic value of careful electrocardiogram analysis in differentiating JET from other narrow-complex tachycardias and preventing unnecessary interventions.

JET should be considered in adults presenting with postoperative narrow-complex tachycardia and atrioventricular dissociation. Accurate electrocardiogram interpretation is essential for appropriate management.