Shaikh Mohammad, Golzarian Hafez, Hakim Fayaz A
Internal Medicine Residency Program, BonSecours Mercy Health-St. Rita's Medical Center, 730 West Market Street, 2K Tower, Lima, OH 45801, USA.
Division of Cardiovascular Diseases, Heart Rhythm Services, St. Rita's Medical Center, Lima, OH 45801, USA.
Eur Heart J Case Rep. 2024 Jul 15;8(8):ytae328. doi: 10.1093/ehjcr/ytae328. eCollection 2024 Aug.
Wide QRS complex (QRS) tachycardia in patients with atrial fibrillation (AF) 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 AF 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.
房颤（AF）或房扑患者在使用抗心律失常药物治疗时出现宽QRS波群（QRS）心动过速的原因多种多样，需要仔细评估以便对患者进行恰当管理。
我们报告1例房颤患者使用氟卡尼治疗时出现宽QRS波群心动过速，该患者因疑似室性心动过速接受了多次体外心脏复律尝试。静脉注射地尔硫䓬和口服β受体阻滞剂使宽QRS波群心动过速得到缓解。
抗心律失常药物的促心律失常作用或频率依赖性现象所致的宽QRS心动过速应列入鉴别诊断。在本简要报告中，我们讨论了鉴别诊断，并概述了对这些患者进行急性和长期管理的实用方法。
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