一名心房颤动患者的宽QRS波心动过速：病例报告及诊断方法

Wide QRS tachycardia in a patient with atrial fibrillation: a case report and approach to diagnosis.

作者信息

Shaikh Mohammad, Golzarian Hafez, Hakim Fayaz A

机构信息

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.

出版信息

Eur Heart J Case Rep. 2024 Jul 15;8(8):ytae328. doi: 10.1093/ehjcr/ytae328. eCollection 2024 Aug.

BACKGROUND

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.

CASE SUMMARY

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.

DISCUSSION

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.