RECURRENT VENTRICULAR TACHYCARDIA IN AN INFANT—USE OF HIGH VOLTAGE DC SHOCK THERAPY IN MANAGEMENT

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Abstract
The case of a 17-month-old infant with ventricular tachycardia has been presented. The diagnosis was confirmed by esophageal and right atrial electrocardiography. No cardiac abnormalities were demonstrated by bilane angiocardiography. Quinidine and steroid therapy were effective temporarily for conversion to normal sinus rhythm. Gradually, conversion became more difficult and sustained ventricular tachycardia became refractory to drug therapy. A Lown Cardioverter was employed with a single countershock discharge of 8 to 15 watt seconds (1,000 to 1,370 volts). The shock was electronically timed to occur at the peak of the QRS complex to avoid the vulnerable period of the cardiac cycle (T-wave), wherein the shock may initiate ventricular fibrillation. Normal sinus rhythm was established on five occasions with the administration of a single shock. Following this therapy, the patient remained well and maintained a normal sinus rhythm for ten months while on Quinaglute duratabs® and reserpine.

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