American Journal of Emergency Medicine
Volume 18, Issue 4 , Pages 453-456, July 2000

Wide QRS tachycardia refractory to pharmacologic interventions and cardioversion☆☆☆★★★

Received 14 July 1999; received in revised form 19 September 1999; accepted 20 September 1999.

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

American Journal of Emergency Medicine
Volume 18, Issue 4 , Pages 453-456, July 2000

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