A 2-month-old infant is 8 hours post–VSD patch closure and PDA ligation. Temperature is 38.3°C, lactate is rising, and CVP is elevated. Temporary atrial and ventricular epicardial pacing wires are in place. The surface ECG (Lead II) and atrial electrogram (AEG) from pacing wires are shown above. Quiz QuestionWhat is the most likely rhythm diagnosis, … Read more
A 3-year-old boy with repaired tetralogy of Fallot (RVOT patch + transannular patch) is admitted to the cardiac ICU with worsening fatigue and presyncope. He is postoperative day 5 following pulmonary valve replacement. He suddenly develops a regular wide-complex tachycardia at 220/min, with MAP decreasing to 45 mmHg despite fluid bolus. Near-infrared spectroscopy demonstrates declining … Read more
A 6-year-old child on postoperative day 2 after atrial septal defect repair develops sudden tachycardia with a heart rate of 160–170/min. Blood pressure is stable but trending downward. The monitor shows a regular narrow-complex tachycardia. The child is irritable with mild hepatomegaly and rising lactate. Adenosine transiently slows the ventricular rate, but the tachycardia immediately … Read more
