title: Accelerated junctional rhythm in children with acute rheumatic fever: is it specific to the disease?
abstract: OBJECTIVE
  During the course of acute rheumatic fever, some electrocardiographic changes are seen. First-degree atrioventricular block is the most common electrocardiographic abnormality. Second- and third-degree atrioventricular block, ventricular tachycardia, and junctional acceleration are also seen. In the present study, the specificity of accelerated junctional rhythm to acute rheumatic fever was INVESTIGATED.
  
  
  METHODS
  The study included patients with acute rheumatic fever (Group 1), healthy children who had suffered from recent group A β-haemolytic streptococcal upper respiratory tract infection but did not develop acute rheumatic fever (Group 2), and patients who had other diseases that may affect the joints and/or heart (Group 3).
  
  
  RESULTS
  Accelerated junctional rhythm was detected in 10 patients in Group 1, but in none of the patients from Group 2 or 3. Specificity of accelerated junctional rhythm for acute rheumatic fever was 100% and the positive predictive value was 100%.
  
  
  CONCLUSIONS
  Accelerated junctional rhythm is specific to acute rheumatic fever. Although its frequency is low, it seems that it can be used in the differential diagnosis of acute rheumatic fever, especially in patients with isolated polyarthritis.
authors.affiliation: 1 Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Naci
authors.initials: N
authors.lastname: Ceviz
authors.affiliation: 2 Department of Pediatrics, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Velat
authors.initials: V
authors.lastname: Celik
authors.affiliation: 1 Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Hasim
authors.initials: H
authors.lastname: Olgun
authors.affiliation: 1 Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Karacan
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002648:Child; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D012213:Rheumatic Fever / Q000150:complications* / Q000503:physiopathology*