Wide QRS Complex Tachycardia in a Patient With Atrial Fibrillation: The Use Dependence Effect of Flecainide Unmasked in a Symptomatic Female

Ezeh, Ebubechukwu; Moroi, Morgan K.; Amro, Mohammad; Ruzieh, Mohammed; Salem, Omar Ben Hadj; Okhumale, Paul I.

doi:10.1016/s0735-1097(22)03438-6

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2022

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“…In terms of noticeable ECG changes, the effect of flecainide is greatly enhanced with higher heart rates and can result in significant intraventricular conduction delays, causing a widened QRS complex [ 4 , 7 ]. Flecainide can also organize atrial fibrillation into slow atrial tachycardia or atrial flutter due to decreased atrial tissue conductance.…”

Section: Discussionmentioning

confidence: 99%

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The Slower, the Better: Wide Complex Tachycardia Triggered by Flecainide in an Elderly Female

Ezeh

Perdoncin

Moroi

et al. 2022

Case Reports in Cardiology

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Class IC antiarrhythmics are generally considered a safe means of treating many common arrhythmias such as atrial fibrillation (a-fib), atrial flutter (a-flutter), and paroxysmal supraventricular tachycardia (PSVT). Essentially, flecainide works by binding and blocking sodium channels more effectively at higher heart rates. However, this class of drugs is known to exhibit use dependence which could predispose patients to the development of malignant arrhythmias during episodes of tachycardia. In this case, we present a patient who was being treated with flecainide for a-fib who ultimately developed a wide complex tachycardia after her metoprolol was held.

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Section: Discussionmentioning

confidence: 99%

“…We present the case of a 70-year-old woman treated with flecainide who developed a wide complex tachycardia after her beta blocker therapy was discontinued. This case was presented as an abstract at the 2022 American College of Cardiology conference in Washington, D.C. [ 4 ].…”

Section: Introductionmentioning

confidence: 99%