Refractory Atrial Tachycardia and Ivabradine in a Case of Catecholaminergic Polymorphic Ventricular Tachycardia

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare hereditary arrhythmia characterized by adrenergic stress-induced polymorphic ventricular tachycardia. Supraventricular arrhythmias, including ectopic atrial tachycardia (EAT), may occur, but their management in patients with CPVT has not been well assessed. This case report presents an 11-year-old boy with CPVT who developed drug-resistant EAT. Despite treatment with beta-blockers, flecainide, and sotalol, EAT persisted. Ivabradine therapy was initiated, resolving the arrhythmia within hours. This unique case highlights ivabradine’s potential as a non-invasive alternative to ablation for EAT in CPVT. Multicenter studies are required to explore its routine use alongside beta-blockers in managing CPVT-related arrhythmias.