Why the study?
The etiology of wide-complex monomorphic tachycardias can be difficult to determine in the emergency department, and treatment depends on hemodynamic status and follows a stepwise approach because initial therapies may be ineffective.
Case Report (n=1)
Pediatric idiopathic ventricular tachycardia can be highly refractory to standard initial therapies like vagal maneuvers and adenosine, requiring stepwise escalation to agents like procainamide.
May support procainamide in refractory pediatric wide-complex tachycardia; leaves open need for prospective data.
Wide-complex, monomorphic tachycardias represent a range of tachyarrhythmias. Such patients can present asymptomatically and hemodynamically stable, while others are in shock. The etiology of the rhythm can be difficult to determine in the emergency department, and although electrocardiogram findings may be helpful, a workup after stabilization may be necessary to determine the cause. Treatment is therefore dependent on hemodynamic status and follows a stepwise approach, as initial therapies may be ineffective. We present the case of a three-year-old girl with wide-complex tachycardia which was exceedingly refractory to preliminary treatments and required trials of multiple treatment approaches to achieve conversion to normal sinus rhythm.
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Domm et al. (2022) conducted a case report in Wide-Complex Tachycardia (n=1). Procainamide was evaluated on Conversion to normal sinus rhythm.
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