Publication Date
6-4-2021
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-19-7099
PMID
34086956
Publication Date(s)
June 2021
Language
English
PMCID
PMC8262829
PubMedCentral® Posted Date
6-4-2021
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Anti-arrhythmia agents/adverse effects/therapeutic use, arrhythmias, cardiac/complications/prevention & control, atrial flutter/chemically induced, cardiac complexes, premature, flecainide/adverse effects, heart conduction system/drug effects, treatment outcome, ventricular fibrillation/complications
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Flecainide, a widely prescribed class IC agent used to treat atrial arrhythmias, can in rare cases cause 1:1 atrial flutter with rapid conduction. We describe the case of a 59-year-old man who was on a maintenance regimen of flecainide for refractory atrial fibrillation. When 1:1 atrial flutter with rapid conduction developed, emergency medical technicians attempted synchronized cardioversion, which caused ventricular fibrillation necessitating defibrillation. The patient ultimately underwent radiofrequency ablation and cryoablation to resolve his symptomatic atrial flutter. We discuss the atrial proarrhythmic effects of flecainide and how to mitigate complications in high-risk patients.