Syncope in patients with atrial flutter during treatment with class Ic antiarrhythmic drugs

We describe 2 atrial flutter (AFL) patients with syncope during treatment with class Ic antiarrhythmic drugs. During the syncope, 1:1 atrioventricular (AV) conduction during AFL preceded a wide QRS tachycardia. The class Ic drugs, flecainide and pilsicainide, slowed the atrial rate, resulting in AFL...

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Bibliographic Details
Published in:Journal of electrocardiology 2001-01, Vol.34 (1), p.65-72
Main Authors: Kawabata, Mihoko, Hirao, Kenzo, Horikawa, Tomoe, Suzuki, Kou, Motokawa, Katsuhiko, Suzuki, Fumio, Azegami, Kouji, Hiejima, Kazumasa
Format: Article
Language:English
Subjects:
Adult
Anti-Arrhythmia Agents - adverse effects
Anti-Arrhythmia Agents - therapeutic use
Antiarrhythmics
atrial flutter
Atrial Flutter - complications
Atrial Flutter - drug therapy
Atrial Flutter - physiopathology
Biological and medical sciences
Catheter Ablation
Class Ic antiarrhythmic drug
Drug toxicity and drugs side effects treatment
Electrocardiography
Electrophysiologic Techniques, Cardiac
exercise
Exercise - physiology
Flecainide - adverse effects
Flecainide - therapeutic use
Humans
Lidocaine - adverse effects
Lidocaine - analogs & derivatives
Lidocaine - therapeutic use
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
proarrhythmia
syncope
Syncope - complications
Syncope - physiopathology
Tachycardia - physiopathology
Tachycardia - therapy
Toxicity: cardiovascular system
β-blocking agent
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Description
Summary:We describe 2 atrial flutter (AFL) patients with syncope during treatment with class Ic antiarrhythmic drugs. During the syncope, 1:1 atrioventricular (AV) conduction during AFL preceded a wide QRS tachycardia. The class Ic drugs, flecainide and pilsicainide, slowed the atrial rate, resulting in AFL with 1:1 AV conduction, and the width of the QRS complexes became wider during the tachycardia. Syncope was abolished after successful radiofrequency catheter ablation of the AFL. These potential proarrhythmic effects of the class Ic drugs should be taken into account in AFL patients, and concomitant use of β-blocking agents would be critical to prevent proarrhythmias.
ISSN:0022-0736
1532-8430
DOI:10.1054/jelc.2001.22034