Key result
Intravenous verapamil successfully terminated fascicular ventricular tachycardia and restored normal sinus rhythm in less than one minute in a 29-year-old man with COVID-19 pneumonia.
Why the study?
Does intravenous verapamil terminate fascicular ventricular tachycardia in a patient with COVID-19?
Case Report (n=1)
Does intravenous verapamil terminate fascicular ventricular tachycardia in a patient with COVID-19?
Intravenous verapamil successfully terminated fascicular ventricular tachycardia in a COVID-19 patient after amiodarone failed, highlighting the importance of accurate VT subtype diagnosis in the emergency department.
Answers are grounded in this paper and cite their sources.
May support verapamil for fascicular VT after amiodarone failure in COVID-19; hypothesis-generating, needs prospective confirmation.
A 29-year-old man with moderate coronavirus disease 2019 (COVID-19) pneumonia presented with a one-day history of palpitations. On examination, he was febrile and tachycardic (pulse rate of 182 beats per minute), with a blood pressure of 120/80 mmHg and oxygen saturation of 96%. Electrocardiography revealed sustained monomorphic wide-complex tachycardia. Carotid sinus massage and adenosine administration were ineffective. Although amiodarone administration slowed the heart rate and relieved his symptoms, sinus rhythm was not restored. We administered intravenous verapamil which terminated his arrhythmia. We diagnosed the patient with fascicular ventricular tachycardia (VT) with a right bundle branch block. He recovered from COVID-19 weeks later. The workup excluded all possible risk factors associated with VT except for COVID-19 infection.
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Almuzghi et al. (2022) conducted a case report in Fascicular Ventricular Tachycardia and COVID-19 (n=1). Intravenous verapamil was evaluated on Termination of arrhythmia and restoration of normal sinus rhythm. Intravenous verapamil successfully terminated fascicular ventricular tachycardia and restored normal sinus rhythm in less than one minute in a 29-year-old man with COVID-19 pneumonia.
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