Refractory Atrial Tachycardia and Ivabradine in a Case of Catecholaminergic Polymorphic Ventricular Tachycardia-Uncorrected Proof

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare hereditary arrhythmia characterized by adrenergic stress-induced polymorphic ventricular tachycardia. Supraventricular arrhythmias, including ectopic atrial tachycardia (EAT), may occur; however, their management in patients with CPVT has not been well established. This case report presents an 11-year-old boy with CPVT who developed drug-resistant EAT. Despite treatment with beta-blockers, flecainide, and sotalol, EAT persisted. Ivabradine therapy was initiated, resolving the arrhythmia within hours. This unique case highlights the potential role of ivabradine as a therapeutic option in carefully selected patients. Multicenter studies are required to further evaluate the potential role of ivabradine alongside beta-blockers in the management of CPVT-related arrhythmias.

Keywords: Antiarrhythmic drugs, catecholaminergic polymorphic ventricular tachycardia, ectopic atrial tachycardia, ivabradine, ventricular tachycardia