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Wide-Complex Tachycardia in a Neonate
Khalifah A Aldawsari1, Kelsey Wilson1, Johannes C von Alvensleben1
1Department of Pediatrics, Section of Cardiology, University of Colorado, Aurora, Colorado, USA.
JACC. Case Reports
|July 30, 2026
Summary
A rare case of wide-complex tachycardia in a neonate highlights diagnostic challenges. Fascicular ventricular tachycardia, treatable with verapamil, is suspected with specific ECG findings in infants without heart defects.
Area of Science:
- Neonatal cardiology
- Pediatric electrophysiology
- Critical care medicine
Background:
- Wide-complex tachycardia (WCT) in neonates is uncommon.
- Supraventricular tachycardia and aberrant conduction are frequent causes.
- Differentiating etiologies is crucial for appropriate management.
Purpose of the Study:
- To report a case of WCT in a neonate.
- To discuss the diagnostic approach to WCT in this age group.
- To highlight the importance of ECG findings in guiding therapy.
Main Methods:
- Case presentation of a 7-day-old infant boy with a heart rate of 208 beats/min.
- Electrocardiogram (ECG) revealed wide-complex tachycardia morphology.
- Clinical assessment included blood pressure and perfusion status.
Main Results:
- The infant presented with a heart rate of 208 beats/min.
- ECG demonstrated wide-complex tachycardia.
- The patient maintained normal blood pressure and adequate perfusion.
Conclusions:
- WCT in neonates is rare, often due to supraventricular tachycardia or aberrant conduction.
- In neonates without congenital heart disease, a superior axis with right bundle branch block morphology on ECG suggests fascicular ventricular tachycardia.
- Verapamil is the preferred treatment for fascicular ventricular tachycardia in this population.
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