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Verapamil-sensitive idiopathic left ventricular tachycardia in pregnancy
J Cleary-Goldman1, C R Salva, J I Infeld
1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Columbia University, Presbyterian Medical Center, New York, New York 10032, USA.
Abstract:
Verapamil-sensitive idiopathic left ventricular tachycardia is a rare diagnosis. A 31-year-old multiparous woman presented with shortness of breath, palpitations and new-onset, wide complex tachycardia at approximately 28 weeks' gestation. Multiple antiarrhythmic agents were administered without resolution of the arrhythmia. Verapamil-sensitive idiopathic left ventricular tachycardia was diagnosed on the basis of a fusion beat with a right bundle branch pattern, a pathognomonic finding, which was noted on an electrocardiogram. Verapamil resulted in conversion to normal sinus rhythm. The patient delivered at term uneventfully. To our knowledge, this is the first description of verapamil-sensitive idiopathic left ventricular tachycardia in pregnancy. The case illustrates that the origin of wide complex tachyarrhythmias should be identified to provide the proper treatment expeditiously.
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