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

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, but their management in patients with CPVT has not been well established. This case report describes 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, and the arrhythmia resolved within hours. This unique case highlights the potential role of ivabradine as a therapeutic option in carefully selected cases. Multicenter studies are needed to further evaluate the 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