Junctional ectopic tachycardia developed in an infant after intraatrial repair of transposition of the great arteries. He failed to respond to medical management and, in moribund condition, underwent His bundle cryoablation. He survived and ultimately did well. Junctional ectopic tachycardia is not uncommon after open heart operations in children and may be lethal. Its genesis, diagnosis, and treatment are now well enough understood to allow successful treatment of nearly all patients.