Wide QRS tachycardia refractory to pharmacologic interventions and cardioversion☆☆☆★★★
Abstract
The case of a 43-year-old man with an idiopathic wide QRS tachycardia resistant to adenosine, lidocaine, procainamide, and multiple electric shocks is described. The tachycardia eventually stopped after a pacing wire was introduced in the right ventricle, inducing a run of rapid ventricular tachycardia. The possible causes of resistance to medications and cardioversion, and alternative treatment modalities are reviewed. (Am J Emerg Med 2000;18:453-456. Copyright © 2000 by W.B. Saunders Company)
Keywords: Tachycardia, electric countershock, adenosine, lidocaine, procainamide, bretylium, amiodarone
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☆ Returned August 17, 1999.
☆☆ Address reprint requests to Paul A. Friedman, MD, Department of Internal Medicine, Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN 55905. Email: pfriedman@mayo.edu
★ Am J Emerg Med 2000;18:453-456.
★★ 0735-6757/00/1804-0020$10.00/0
PII: S0735-6757(00)93312-6
© 2000 W.B. Saunders Company. All rights reserved.
