Key result
Intravenous diltiazem terminates adenosine-refractory repetitive multiform narrow complex tachycardia in a single case.
Case Report (n=1)
Intravenous diltiazem successfully terminated a repetitive multiform narrow complex tachycardia that was unresponsive to adenosine in a 73-year-old man.
May support diltiazem after adenosine failure; leaves open generalizability and mechanism.
A 73-year-old man presented to the emergency department with palpitations. After experiencing transient exertional palpitations and dyspnea a few months earlier, investigation revealed moderate left ventricular dysfunction and extensive coronary artery disease with evidence of prior inferior infarction. He underwent bypass grafting and remained symptom free with normalization of his ejection fraction until the current presentation. Figure 1 demonstrates his presenting rhythm that did not respond to adenosine but terminated with intravenous diltiazem.
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Wong et al. (2023) conducted a case report in Repetitive multiform narrow complex tachycardia (n=1). Intravenous diltiazem vs. Adenosine was evaluated on Termination of rhythm. In a 73-year-old man with repetitive multiform narrow complex tachycardia, the presenting rhythm did not respond to adenosine but terminated with intravenous diltiazem.
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