Fascicular Ventricular Tachycardia (VT) is a unique clinical syndrome, rarely encountered by physicians. It is also known as Belhassen Syndrome, named after a physician who reported the case in 1981. The condition, accounts for 10-15% of total idiopathic VT and the rhythm is sensitive to calcium channel blocker. First described in 1979, the diagnosis of this syndrome remains challenging, as the electrocardiogram (ECG) may be classified as Supraventricular Tachycardia (SVT) with aberrant conductions.
We described a patient who presented to Emergency Department with palpitation. The difficulty in diagnosis and management is illustrated in the report as he was initially misdiagnosed as SVT with resistance to initial standard treatment. This case report also described wide complex tachycardia algorithms to assist physician in daily clinical practice. Therapeutic options in managing this rare syndrome were also discussed.