Key result
Wide-complex tachycardia in neonates with a superior axis and right bundle branch block morphology suggests fascicular ventricular tachycardia, for which verapamil is the preferred therapy.
Case Report (n=1)
This case highlights that wide-complex tachycardia with RBBB morphology and superior axis in a neonate suggests fascicular ventricular tachycardia, for which verapamil is the preferred therapy.
CASE SUMMARY: A 7-day-old previously healthy infant boy born at 36 6/7 weeks gestation was found in a routine well-child visit to have a heart rate of 208 beats/min. Electrocardiogram demonstrated a wide-complex tachycardia morphology while maintaining normal blood pressure and adequate perfusion. TAKE-HOME MESSAGES: Wide-complex tachycardia in neonates is uncommon, with supraventricular tachycardia and aberrant conduction being the most frequent etiology. In the absence of congenital heart disease, a superior axis with right bundle branch block morphology on electrocardiogram is suggestive of fascicular ventricular tachycardia, for which verapamil is the preferred therapy.
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Aldawsari et al. (2026) conducted a case report in Wide-complex tachycardia (n=1). Verapamil was evaluated. Wide-complex tachycardia in neonates with a superior axis and right bundle branch block morphology suggests fascicular ventricular tachycardia, for which verapamil is the preferred therapy.
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