radiofrequency catheter ablation of the accessory pathway or alternative parts of the re-entrant circuit.
antiarrhythmic drugs are used if ablation is unavailable or unsuccessful, if the patient refuses the interventional procedure, or whilst awaiting ablation therapy.
drug therapy is aimed at different parts of the 'circuit' behind the aetiology of the junctional tachycardia:
prolongation of the recovery of the AV node (eg verapamil) or of the accessory pathways (eg amiodarone).
prevention of the initiation mechanism eg suppression of ectopic activity with flecainide.
prophylaxis aimed at specific situations in which the arrhythmia occurs eg á blockers if arrhythmias occur at time of exercise.
impairment of the ability of the accessory pathways to conduct frequent impulses from the atrium to the ventricle eg amiodarone.
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