This protocol addresses the acute management of idiopathic fascicular ventricular tachycardia in patients who are haemodynamically tolerated — presenting without signs of haemodynamic instability.
Clinical scenario: Idiopathic fascicular ventricular tachycardia, haemodynamically tolerated. The absence of haemodynamic compromise permits a pharmacological approach to acute termination rather than immediate electrical intervention.
In this haemodynamically stable setting, an intravenous calcium channel blocker is the recommended agent for acute conversion of fascicular VT — the complete regimen, repeat dosing guidance, and sequencing are detailed in the full protocol.
DOI: 10.1093/eurheartj/ehac262
In patients presenting with a haemodynamically tolerated idiopathic VT, treatment with intravenous beta-blocker (RVOT VT) or verapamil (fascicular VT) is recommended.
In case of a known idiopathic VT (Figure 4), treatment with beta-blockers (for RVOT VT) or verapamil (for fascicular VT) is recommended for acute conversion.
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