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Verapamil sensitive idiopathic ventricular tachycardia in an infant
Jiaan-Der Wang1, Yun-Ching Fu, Sheng-Ling Jan
1Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Insights
This case study highlights verapamil-sensitive idiopathic ventricular tachycardia in an infant. Verapamil effectively controlled the tachycardia originating from the left posterior fascicle, a rare pediatric cardiac condition.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Idiopathic ventricular tachycardia (IVT) is uncommon in infants.
- Early diagnosis and effective management are crucial for pediatric patients.
Observation:
- An 8-month-old female infant presented with significant tachycardia (186 bpm).
- Electrocardiogram revealed a right bundle branch block pattern, superior QRS axis, and atrioventricular dissociation.
- Initial treatments with lidocaine, propranolol, and amiodarone were unsuccessful.
Findings:
- Verapamil successfully terminated and controlled the infant's tachycardia.
- The diagnosis of verapamil-sensitive IVT was established, with the origin identified in the left posterior fascicle.
- This suggests a specific electrophysiological characteristic responsive to verapamil.
Implications:
- Verapamil should be considered as a treatment option for specific pediatric IVT cases.
- Understanding the fascicular origin is key for targeted therapy in infants.
- This case expands knowledge on rare pediatric arrhythmias and their management.
Abstract:
Idiopathic ventricular tachycardia is rare, especially in infants. We report here on an 8 month-old female infant who presented with tachycardia with a heart rate of 186 beats/ min. An electrocardiogram showed a right bundle branch block pattern, a QRS duration of 80 msec, a superior QRS axis, atrioventricular dissociation, and occasional fusion and capture beats. Suspected ventricular tachycardia was treated with lidocaine, propranolol and amiodarone, but in vain. The tachycardia was terminated and well controlled with the use of verapamil. According to an electrocardiogram and her clinical response, verapamil-sensitive idiopathic ventricular tachycardia was diagnosed with the arrhythmic origin in the left posterior fascicle.