Adolfo Boada, Stephanie Plaza*, Mario Cabrera and Christian Nolte
Idiopathic fascicular ventricular tachycardia (IFVT) of the left ventricle is an infrequent form of ventricular tachycardia (VT), usually occurring in patients without structural heart disease, sensitive to verapamil and whose mechanism is reentry using the specific conduction system of the left ventricle . The most frequents are VTs that compromise the posterior fascicle, constituting 90% of cases . Energy drinks have been associated with supraventricular and ventricular cardiac arrhythmias in young patients without known heart disease. We present the case of a 36-year-old male patient, with no known medical history, who after ingesting an energy drink (VOLT®) suddenly presented a non-radiated precordial pain and palpitations, was translated to emergency room, where an electrocardiogram (ECG) was performed showing a VT with wide QRS and right bundle branch block morphology, with an axis deviated to the left, it was decided to administer verapamil 5 mg intravenously, achieving reversion to sinus rhythm, progressive elevation of troponin T was observed, for which cardiac catheterization was performed without evidence of lesions in the coronary arteries. The presence of structural heart disease was ruled out with cardiac magnetic resonance imaging. The diagnosis of FVT triggered by the consumption of an energy drink in a structurally healthy heart was established, treatment with Bisoprolol 2.5 mg orally daily was indicated, caffeine intake was prohibited, and a schedule of outpatient controls was established.
