CASE REPORT article
Front. Pediatr.
Sec. Pediatric Cardiology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1662114
This article is part of the Research TopicAdvancing Our Understanding of the Cardiac Conduction System to Prevent ArrhythmiasView all 7 articles
Adenosine-Induced Atrioventricular Dissociation: Unmasking Monomorphic Tachycardia as a Diagnostic Challenge in a Neonate
Provisionally accepted
- 1Ordos Center Hospital, Ordos, China
- 2Qingdao Municipal Hospital Group, Qingdao, China
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Background: Neonatal monomorphic tachycardia poses a diagnostic challenge. This report demonstrates how adenosine-induced AV dissociation confirmed ventricular tachycardia. Case: A 3-day-old preterm neonate (34+2 weeks) presented with refractory monomorphic tachycardia (217 bpm; QRS 92 ms) initially diagnosed as SVT based on 1:1 retrograde P-waves. Adenosine administration induced atrioventricular dissociation without termination—a finding inconsistent with SVT. Retrospective ECG analysis revealed prolonged QRS duration during tachycardia (92 ms vs. 60 ms post-cardioversion) and delta wave-like slurring, confirming VT diagnosis. Synchronized cardioversion (0.5 J/kg) restored sinus rhythm, followed by metoprolol prophylaxis. Conclusion: This case highlights that monomorphic tachycardia in neonates may represent VT. Adenosine's role in inducing AV dissociation is pivotal for diagnosis, and low-energy cardioversion with β-blocker maintenance offers an effective rescue strategy. Clinicians must reassess ECG features dynamically to avoid misclassification.
Keywords: Monomorphic, Tachycardia, neonate, Electrocardiography, Adenosine
Received: 08 Jul 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 Wang, Wu, Huang, Yaletai and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Peng Liu, wanguyisu@163.com
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