Verapamil-sensitive fascicular ventricular tachycardia precipitated by promethazine overdose.
S, H., A, C., & A, N. (2026). Verapamil-sensitive fascicular ventricular tachycardia precipitated by promethazine overdose.. BMJ case reports. https://doi.org/10.1136/bcr-2025-271685
S H, A C, A N. Verapamil-sensitive fascicular ventricular tachycardia precipitated by promethazine overdose.. BMJ case reports. 2026; doi: 10.1136/bcr-2025-271685
S H, A C, A N. Verapamil-sensitive fascicular ventricular tachycardia precipitated by promethazine overdose.[J]. BMJ case reports. 2026. DOI: 10.1136/bcr-2025-271685.
@article{s2026,
author = {Hassan S and Carpenter A and Nisbet A},
title = {Verapamil-sensitive fascicular ventricular tachycardia precipitated by promethazine overdose.},
journal = {BMJ case reports},
year = {2026},
doi = {10.1136/bcr-2025-271685},
note = {PMID: 42637509},
}
TY - JOUR AU - Hassan S AU - Carpenter A AU - Nisbet A TI - Verapamil-sensitive fascicular ventricular tachycardia precipitated by promethazine overdose. T2 - BMJ case reports PY - 2026 DO - 10.1136/bcr-2025-271685 AN - PMID:42637509 ER -
Verapamil-sensitive fascicular tachycardia is a type of ventricular tachycardia (VT) involving the specialised cardiac conducting tissue. Drug overdose is an important cause to consider when assessing patients with a new presentation of a broad complex tachycardia. Multiple antihistamines have been implicated as pro-arrhythmic, but these tend to precipitate Torsades de Pointes via drug-induced QT prolongation. We present an educational case of a Verapamil-sensitive fascicular VT with typical electrocardiogram (ECG) characteristics, which developed immediately following an overdose of promethazine and which was terminated successfully with verapamil, in a young person with a structurally normal heart. There have been no previous published reports of promethazine precipitating a fascicular VT and we aim to highlight this unusual link and the benefits of early recognition and management of similar presentations.