Paired Ventricular Pacing: An Alternative Therapy for Postoperative Junctional Ectopic Tachycardia in Congenital Heart Disease

junctional ectopic tachycardia (JET) is one of the most life‐threatening postoperative arrhythmias in children with congenital heart disease, and medical management is difficult. Paired ventricular pacing (PVP) may provide a safe alternative mode of management. We evaluated the safety and efficacy of PVP for the management of postoperative JET in patients with congenital heart disease. A retrospective collection of data was done from 1981–1995. PVP was successfully tried in five postoperative patients (age range: 37 days to 22 years, median: 10 months). Onset of JET was 3–60 hours (mean ± SD, 19 ± 23 hours) postoperatively. The maximal JET rate was 261 ± 39 beats/min. PVP was used as the first line of management in three patients and was successful in all patients. It resulted in an instantaneous increase in blood pressure from 66 ± 9 to 94 ± 15 mmHg (42% increase) and was required for 12 ± 14 hours (range 2–36 hours). No complications were noted. Therefore, in our experience, this is a safe alternative modality for the control of postoperative JET.