Verapamil-sensitive idiopathic left ventricular tachycardia in a 6-month-old: Unique considerations in diagnosis and management in an infant

Gurumurthy Hiremath, Walter Li, Rhonda Foltz, Arup Roy-Burman, Mark Cocalis, Ronn E. Tanel

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Idiopathic left ventricular tachycardia of the Belhassen type is rare in infants. We present a 6-month-old infant girl with a wide-complex tachycardia with right bundle branch block QRS morphology, a superior axis, and atrioventricular dissociation, consistent with a left anterior fascicular tachycardia. Initial echocardiogram revealed depressed ventricular function. The tachycardia was unresponsive to therapeutic trials of adenosine, esmolol, procainamide, and lidocaine. There was brief conversion of the tachycardia to sinus rhythm with transesophageal atrial overdrive pacing, suggesting a reentrant mechanism of the arrhythmia. Ultimately, the judicious administration of intravenous verapamil resulted in termination of the arrhythmia, which has been sustained on oral therapy.

Original languageEnglish (US)
Pages (from-to)50-53
Number of pages4
JournalPediatric Emergency Care
Volume31
Issue number1
DOIs
StatePublished - Jan 21 2015

Keywords

  • adenosine
  • infant
  • ventricular tachycardia
  • verapamil

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