{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:03Z","timestamp":1753876263733,"version":"3.41.2"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Wide QRS complex (QRS) tachycardia in patients with atrial fibrillation (AF) or atrial flutter treated with antiarrhythmic drugs can occur for a variety of reasons and needs careful evaluation for appropriate management of the patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report a case of wide QRS complex tachycardia in a patient with AF treated with Flecainide who received multiple external cardioversion attempts for a presumed diagnosis of ventricular tachycardia. Intravenous Diltiazem and an oral beta-blocker led to the resolution of wide QRS complex tachycardia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Wide QRS tachycardia due to pro-arrhythmic effect or rate-dependency phenomenon of antiarrhythmic agents should be included in the differentials. In this brief report, we discuss the differential diagnosis and outline a practical approach for acute and long-term management of these patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae328","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T16:59:11Z","timestamp":1721062751000},"source":"Crossref","is-referenced-by-count":1,"title":["Wide QRS tachycardia in a patient with atrial fibrillation: a case report and approach to diagnosis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3676-9738","authenticated-orcid":false,"given":"Mohammad","family":"Shaikh","sequence":"first","affiliation":[{"name":"Internal Medicine Residency Program, BonSecours Mercy Health\u2014St. Rita\u2019s Medical Center , 730 West Market Street, 2K Tower, Lima, OH 45801 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-6525","authenticated-orcid":false,"given":"Hafez","family":"Golzarian","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program, BonSecours Mercy Health\u2014St. Rita\u2019s Medical Center , 730 West Market Street, 2K Tower, Lima, OH 45801 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fayaz A","family":"Hakim","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Heart Rhythm Services, St. Rita\u2019s Medical Center , Lima, OH 45801 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"2024080510224791300_ytae328-B1","first-page":"283","article-title":"Frequency-dependent effects of antiarrhythmic drugs on action potential duration and refractoriness of canine cardiac purkinje fibers.","volume":"229","author":"Nattel","year":"1984","journal-title":"J Pharmacol Exp Ther"},{"key":"2024080510224791300_ytae328-B2","first-page":"575","article-title":"Mechanism of flecainide\u2019s rate-dependent actions on action potential duration in canine atrial tissue","volume":"267","author":"Wang","year":"1993","journal-title":"J Pharmacol Exp Ther"},{"key":"2024080510224791300_ytae328-B3","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1038\/clpt.1993.9","article-title":"Pharmacodynamic variability of flecainide assessed by QRS changes","volume":"53","author":"Padrini","year":"1993","journal-title":"Clin Pharmacol Ther"},{"key":"2024080510224791300_ytae328-B4","doi-asserted-by":"crossref","first-page":"433","DOI":"10.3109\/15563659009038586","article-title":"Clinical course and outcome in class 1C antiarrhythmic overdose.","volume":"28","author":"Koppel","year":"1990","journal-title":"J Toxicol Clin Toxicol"},{"key":"2024080510224791300_ytae328-B5","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1001\/jamacardio.2021.0852","article-title":"Assessment of catheter ablation or antiarrhythmic drugs for first-line therapy of atrial fibrillation: a meta-analysis of randomized clinical trials","volume":"6","author":"Turagam","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2024080510224791300_ytae328-B6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"2024080510224791300_ytae328-B7","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae328\/58546826\/ytae328.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/8\/ytae328\/58734193\/ytae328.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/8\/ytae328\/58734193\/ytae328.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T10:23:11Z","timestamp":1722853391000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae328\/7713860"}},"subtitle":[],"editor":[{"given":"Stefano","family":"Bordignon","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Christoph","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Peregrine","family":"Green","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Neil","family":"Bodagh","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Sara","family":"Monosilio","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":7,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae328","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2024,7,15]]},"article-number":"ytae328"}}