Verapamil-sensitive ventricular tachycardia in an infant

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Neonatal Medicine

Background:

• Infantile tachycardia poses diagnostic and therapeutic challenges.
• Right bundle branch, superior axis ventricular tachycardia (VT) is uncommon in infants.
• Standard antiarrhythmic drugs and cardioversion are often ineffective.

Observation:

• A 6-month-old infant presented with rapid VT (197 bpm).
• The VT was refractory to adenosine, propranolol, flecainide, and amiodarone.
• Synchronized cardioversion also failed to terminate the arrhythmia.

Findings:

• Overdrive atrial pacing successfully terminated the tachycardia.
• Initiation of verapamil resulted in no recurrence of VT.
• This suggests a verapamil-sensitive mechanism for the tachycardia.

Implications:

• Verapamil-sensitive VT should be considered in infants with refractory VT.
• Prompt recognition and targeted therapy can prevent recurrent episodes.
• This case expands understanding of pediatric VT management.