Wide-Complex Tachycardia in a Neonate.

CASE SUMMARY: A 7-day-old previously healthy infant boy born at 36 6/7 weeks gestation was found in a routine well-child visit to have a heart rate of 208 beats/min. Electrocardiogram demonstrated a wide-complex tachycardia morphology while maintaining normal blood pressure and adequate perfusion.

TAKE-HOME MESSAGES: Wide-complex tachycardia in neonates is uncommon, with supraventricular tachycardia and aberrant conduction being the most frequent etiology. In the absence of congenital heart disease, a superior axis with right bundle branch block morphology on electrocardiogram is suggestive of fascicular ventricular tachycardia, for which verapamil is the preferred therapy.