Fascicular Ventricular Tachycardia in Pregnancy
Maddison Weber1, Ameya Chinawalkar1, Amjad Kabach1
1Creighton University Medical Center, Omaha, Nebraska, USA.
Background:
Fascicular ventricular tachycardia (VT) is an uncommon form of VT, typically verapamil sensitive, and unusual in pregnancy.
Case Summary:
A 28-year-old woman at 32 weeks' gestation presented with palpitations, dyspnea, and dizziness. Electrocardiogram showed sustained wide-complex tachycardia with right bundle branch block and left-axis deviation. Echocardiography was normal. Holter confirmed frequent ventricular runs.
Discussion:
Catheter ablation was deferred due to fetal risk, and verapamil was avoided. Careful inpatient beta-blocker titration controlled arrhythmia and relieved symptoms. Multidisciplinary management was essential.
Take-Home Message:
Fascicular VT in pregnancy is rare. Beta-blockade can stabilize maternal symptoms, while ablation is reserved for postpartum definitive therapy.
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