ISSN 1016-5169 | E-ISSN 1308-4488
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Fingers on the Wrist and Taming the Funny Current, Rejuvenate the Wounded Heart: Ivabradine-Responsive Atrial Tachycardia [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2023; 51(8): 580-583 | DOI: 10.5543/tkda.2023.60296

Fingers on the Wrist and Taming the Funny Current, Rejuvenate the Wounded Heart: Ivabradine-Responsive Atrial Tachycardia

A. Shaheer Ahmed, Gauravkumar Divani, Nitish Rai, Anwar Hussain Ansari
Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

A 19-year-old male presented with dyspnea on exertion (New York Heart Association [NYHA] class II) and occasional palpitations for six months. He had initially been evaluated at another facility and diagnosed with dilated cardiomyopathy. Despite treatment, there was no improvement in his symptoms. On evaluation at our centre, his previous electrocardiograms appeared normal. However, palpation of his radial pulse for one minute revealed runs of regular tachycardia, interspersed with a normal pulse rate. A 30-second rhythm strip electrocardiogram (ECG) showed multiple runs of ectopic tachycardia originating from the right atrial appendage, interspersed with ectopic atrial rhythms. Echocardiography showed severe left ventricle (LV) dysfunction with an ejection fraction of 20-25%. Radio-frequency ablation was recommended, but the patient declined. Instead, he was started on Ivabradine. After a month, his symptoms fully resolved. The ECG displayed a normal sinus rhythm with no tachycardia, and his left ventricular ejection function improved.

Keywords: Arrhythmia, heart failure, left ventricular dysfunction, supraventricular tachycardia

Corresponding Author: A. Shaheer Ahmed, India
Manuscript Language: English
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