{"title":"Wide QRS Tachycardia in a Patient with Atrial Fibrillation: A Case Report and Approach to Diagnosis","authors":"Mohammad Shaikh, Hafez Golzarian, F. Hakim","doi":"10.1093/ehjcr/ytae328","DOIUrl":null,"url":null,"abstract":"\n \n \n Wide QRS tachycardia in patients with atrial fibrillation or atrial flutter treated with antiarrhythmic drugs can occur for a variety of reasons and needs careful evaluation for appropriate management of the patient.\n \n \n \n We report a case of wide QRS complex tachycardia in a patient with atrial fibrillation treated with Flecainide who received multiple external cardioversion attempts for a presumed diagnosis of ventricular tachycardia. Intravenous Diltiazem and an oral beta blocker led to the resolution of wide QRS complex tachycardia.\n \n \n \n Wide QRS tachycardia due to pro-arrhythmic effect or rate dependency phenomenon of antiarrhythmic agents should be included in the differentials. In this brief report, we discuss the differential diagnosis and outline a practical approach for acute and long-term management of these patients.\n","PeriodicalId":507701,"journal":{"name":"European Heart Journal - Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjcr/ytae328","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Wide QRS tachycardia in patients with atrial fibrillation or atrial flutter treated with antiarrhythmic drugs can occur for a variety of reasons and needs careful evaluation for appropriate management of the patient.
We report a case of wide QRS complex tachycardia in a patient with atrial fibrillation treated with Flecainide who received multiple external cardioversion attempts for a presumed diagnosis of ventricular tachycardia. Intravenous Diltiazem and an oral beta blocker led to the resolution of wide QRS complex tachycardia.
Wide QRS tachycardia due to pro-arrhythmic effect or rate dependency phenomenon of antiarrhythmic agents should be included in the differentials. In this brief report, we discuss the differential diagnosis and outline a practical approach for acute and long-term management of these patients.
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