Ivabradine as a treatment option for junctional ectopic tachycardia in an adult female

Abstract

AbstractA Junctional ectopic tachycardia diagnosis was performed using two electrophysiological maneuvers in an adult female with a narrow‐complex supraventricular tachycardia with a bystander AV‐node slow pathway conduction, who previously underwent catheter ablation attempts for an atrio‐ventricular nodal re‐entrant tachycardia misdiagnosis. The first maneuver was atrial entrainment with an atrial‐His‐His‐atrial response. The second was based on the response to a premature atrial complex delivered at different phases of the tachycardia cycle confirming that anterograde slow pathway conduction and retrograde fast pathway were not involved. Considering that verapamil, diltiazem, bisoprolol + flecainide, and nadolol were ineffective, we tried ivabradine with no sustained arrhythmias during 18‐months.