{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:32:41Z","timestamp":1761921161603,"version":"3.41.2"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We describe a child with a broad and narrow complex tachycardia causing haemodynamic collapse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 9-year-old girl (weight 26\u2005kg, height 114\u2005cm) with a 5-year history of refractory \u2018epilepsy\u2019 presented with cardiorespiratory arrest and tonic-clonic seizure, witnessed by her mother. Electrocardiogram documented recurrent episodes of simultaneous broad and narrow tachycardias associated with haemodynamic compromise. Diagnostic electrophysiologic study (EPS) confirmed a dual tachycardia mechanism. The challenge in selecting the optimal treatment strategy is discussed. A diagnosis of dual tachycardia was made with catecholaminergic polymorphic ventricular tachycardia (CPVT) and simultaneous focal atrial tachycardia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Bidirectional ventricular tachycardia (VT) induced by isoproterenol in this clinical scenario is strongly suggestive of CPVT. Diagnostic EPS can be useful in challenging clinical situations to understand the mechanism of arrhythmias and to tailor the most appropriate treatment strategy. Combination therapy with nadolol and flecainide is highly effective in ventricular arrhythmia control. Implantable cardioverter defibrillator implantation is not without risk in CPVT as there is a potential of electrical storm driven by shock therapy that increases adrenergic drive. Cervical sympathectomy may be considered if further VTs occur in future despite optimum medical therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad490","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T15:54:44Z","timestamp":1696434884000},"source":"Crossref","is-referenced-by-count":3,"title":["Broad and narrow complex tachycardia resulting in cardiorespiratory arrest in a child: what is the optimal treatment strategy?"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5829-642X","authenticated-orcid":false,"given":"Shankar N","family":"Sadagopan","sequence":"first","affiliation":[{"name":"Paediatric and Adult Cardiology, University Hospitals Southampton, Tremona Road, Southampton SO166YD , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur M","family":"Yue","sequence":"additional","affiliation":[{"name":"Paediatric and Adult Cardiology, University Hospitals Southampton, Tremona Road, Southampton SO166YD , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"key":"2023101913295779700_ytad490-B1","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1253\/circj.71.1606","article-title":"Association of atrial arrhythmia and sinus node dysfunction in patients with catecholaminergic polymorphic ventricular tachycardia","volume":"71","author":"Sumitomo","year":"2007","journal-title":"Circ J"},{"key":"2023101913295779700_ytad490-B2","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1161\/CIRCEP.111.965947","article-title":"How to perform and interpret provocative testing for the diagnosis of Brugada syndrome, long-QT syndrome, and catecholaminergic polymorphic ventricular tachycardia","volume":"4","author":"Obeyesekere","year":"2011","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023101913295779700_ytad490-B3","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.hrthm.2022.03.1225","article-title":"European Heart Rhythm Association (EHRA)\/Heart Rhythm Society (HRS)\/Asia Pacific Heart Rhythm Society (APHRS)\/Latin American Heart Rhythm Society (LAHRS) expert consensus statement on the state of genetic testing for cardiac diseases","volume":"19","author":"Wilde","year":"2022","journal-title":"Heart Rhythm"},{"key":"2023101913295779700_ytad490-B4","doi-asserted-by":"crossref","first-page":"476","DOI":"10.2174\/1389557517666170707100923","article-title":"A focus on pharmacological management of catecholaminergic polymorphic ventricular tachycardia","volume":"18","author":"Claudio","year":"2018","journal-title":"Mini Rev Med Chem"},{"key":"2023101913295779700_ytad490-B5","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1016\/j.hrthm.2013.05.014","article-title":"HRS\/EHRA\/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013","volume":"10","author":"Priori","year":"2013","journal-title":"Heart Rhythm"},{"key":"2023101913295779700_ytad490-B6","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jccase.2018.09.004","article-title":"Radiofrequency catheter ablation for drug-refractory atrial tachyarrhythmias in a patient with catecholaminergic polymorphic ventricular tachycardia: a case report","volume":"19","author":"Kawada","year":"2018","journal-title":"J Cardiol Cases"},{"key":"2023101913295779700_ytad490-B7","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1093\/eurheartj\/ehac134","article-title":"Cardiac sympathetic denervation in the prevention of genetically mediated life-threatening ventricular arrhythmias","volume":"43","author":"Schwartz","year":"2022","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - 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