Idiopathic Left Ventricular Tachycardia in an 11-Year-Old Boy

IMAGE: Electrocardiogram demonstrating idiopathic fascicular left ventricular tachycardia. CASE SUMMARY: An 11-year-old boy with a history of tuberous sclerosis-related intractable epilepsy exhibited an idiopathic ventricular tachycardia that was resistant to multiple antiarrhythmic treatments, but was responsive to verapamil. We discuss the recognition and treatment of verapamil-sensitive fascicular left ventricular tachycardia. TAKE-HOME MESSAGES: Idiopathic fascicular left ventricular tachycardia in pediatric patients is an uncommon but recognizable arrhythmia. Its management differs from that of more commonly occurring pediatric wide-complex arrhythmias in that it readily responds to verapamil.