Edit concept Question Editor Create issue ticket

Flecainide

Flecainide Toxicity


Presentation

  • This presentation was consistent with flacainide cardiotoxicity exacerbated by electrolyte disturbance. The syncopal episodes probably represented life-threatening arrhythmias.[ncbi.nlm.nih.gov]
  • Drug-induced pneumonitis should be suspected in patients treated with flecainide presenting with subacute diffuse infiltrative lung disease.[ncbi.nlm.nih.gov]
  • We present a case of flecainide-induced hyponatremia in a 67-year-old woman who was treated for paroxysmal atrial tachycardia.[ncbi.nlm.nih.gov]
  • A 30-yr-old male with a history of depression presented after a severe flecainide overdose with plasma concentrations exceeding 20 times the upper boundary of the therapeutic range.[ncbi.nlm.nih.gov]
  • On the day of presentation, he underwent an exercise test as part of his job requirements. While running, he felt lightheaded and experienced a syncopal event and cardiac arrest.[ncbi.nlm.nih.gov]
Orthopnea
  • (6) recurrent myocardial infarction, identified according to the same criteria as the qualifying myocardial infarction 18 ; (7) congestive heart failure, indicated by the presence of two or more signs or symptoms (dyspnea, easy fatigability, edema, orthopnea[doi.org]
Rales
  • […] criteria as the qualifying myocardial infarction 18 ; (7) congestive heart failure, indicated by the presence of two or more signs or symptoms (dyspnea, easy fatigability, edema, orthopnea, paroxysmal nocturnal dyspnea, jugular venous distention, pulmonary rales[doi.org]
Liver Dysfunction
  • Discontinue if liver dysfunction, blood dyscrasias occur. Pregnancy (Cat.C). Nursing mothers: not recommended. Pharmacologic Class: Class IC antiarrhythmic. Interactions: Increased digoxin toxicity.[empr.com]
  • The half-life may be prolonged two-fold or more in patients with liver dysfunction 10. Clearance The mean systemic clearance observed for intravenously administered lidocaine in a study of 15 adults was approximately 0.64 /- 0.18 L/min 11.[drugbank.ca]
Hypotension
  • The patient developed a broad-QRS-tachycardia and severe hypotension.[ncbi.nlm.nih.gov]
  • Consequently, she developed bradycardia, hypotension, and complete heart block. In addition to supportive care, she also received sodium bicarbonate, atropine, calcium gluconate, and dopamine in an effort to reverse the heart block.[ncbi.nlm.nih.gov]
  • Hypertonic sodium bicarbonate is recognized as effective therapy for hypotension and arrhythmias. More recent case reports have concentrated on the use of cardiopulmonary bypass.[ncbi.nlm.nih.gov]
  • The lack of effects of vernakalant on human resistance artery tone and ventricular muscle contractile function suggests that direct vasorelaxant and inotropic effects do not underlie the rare hypotensive events observed clinically with vernakalant, raising[ncbi.nlm.nih.gov]
  • Of 16 dogs that received flecainide infusion, 12 had one or more complications: 6 had ventricular fibrillation resistant to defibrillation, 6 developed severe hypotension after successful defibrillation and 5 had spontaneous ventricular fibrillation after[content.onlinejacc.org]
Jugular Venous Distention
  • venous distention, pulmonary rales, or S 3 ); congestive heart failure was considered to be new if these findings were not present at base line and was considered to be worsened if the patient's symptomatic state deteriorated by one or more New York[doi.org]
Refractory Shock
  • Venoarterial extracorporeal membrane oxygenation should be strongly considered for refractory shock and/or cardiac arrest secondary to flecainide toxicity.[ncbi.nlm.nih.gov]
Pruritus
  • Recruiting Treatment Post-Dural Puncture Headache / Sphenopalatine Ganglion Block 1 2 Recruiting Treatment Prostate Cancer 1 2 Terminated Supportive Care Neoplasms, Malignant 1 2 Terminated Treatment Dry Macular Degeneration 1 2 Terminated Treatment Pruritus[drugbank.ca]
Cold, Clammy Skin
  • After the fourth dose he developed lethargy, cold clammy skin, and a heart rate of 40 beats/min with no palpable pulse. The patient was given 0.1 mg of atropine intravenously, with an increase of the heart rate to 160 beats/min.[ncbi.nlm.nih.gov]
Altered Mental Status
  • A 62-year-old man with a medical history of AF was admitted to our emergency department for altered mental status.[ncbi.nlm.nih.gov]

Workup

Left Axis Deviation
  • He had incomplete left bundle branch block with left-axis deviation. At the electrophysiology study, a prolonged HV interval was observed at baseline, and the tachycardia could be reproduced after ajmaline infusion.[ncbi.nlm.nih.gov]
QTc Interval Prolonged
  • On the surface electrocardiogram this results in QTc interval prolongation. Overdose with class Ic drugs ( 0.1% of total intoxications) is uncommon, but management is difficult and the mortality high [1].[ncbi.nlm.nih.gov]
First-Degree Atrioventricular Block
  • Initiation of flecainide treatment provided sinus rhythm without prolongation of QRS and QTc, bradycardia and first-degree atrioventricular block at a serum flecainide level of 438 ng/mL. Then, he received cardiac resynchronization therapy (CRT).[ncbi.nlm.nih.gov]
Torsades De Pointes
  • . : Torsades de Pointes Ventricular Tachycardia Induced by Mosapride and Flecainide in the Presence of Hypokalemia.[doi.org]
  • We report a 68-year-old man who developed torsades de pointes ventricular tachycardia induced by combined use of mosapride and flecainide.[ncbi.nlm.nih.gov]
  • We present the case of a patient who, shortly after beginning treatment with flecainide, was admitted because of syncope related to bradyarrhythmias, long QT, and torsade-de-pointes.[ncbi.nlm.nih.gov]
  • KEYWORDS: QT interval; antiarrhythmic drugs; atrial fibrillation; flecainide; torsades de pointes[ncbi.nlm.nih.gov]

Treatment

  • If the treatment was necessary, then flecainide was used as first-line treatment in all cases. RESULT: Among the study group, there were 21 (91.3%) cases of SVT and 2 (8.6%) cases of Atrial Flutter (AF).[ncbi.nlm.nih.gov]
  • CONCLUSION: Flecainide and digoxin combination treatment offers a safe and effective treatment for foetal supraventricular tachycardia with fast restoration of sinus rhythm.[ncbi.nlm.nih.gov]
  • In individual patients sotalol was the most frequently effective drug (effective in 89% of patients) and is a suitable choice for first line treatment.[doi.org]
  • BACKGROUND: The optimal treatment for fetal supraventricular tachycardia (SVT) with 1:1 atrioventricular relationship is unclear. OBJECTIVE: We compared the effectiveness of transplacental treatment protocols used in 2 centers.[ncbi.nlm.nih.gov]

Prognosis

  • Probst , Sodium channel blocker tests allow a clear distinction of electrophysiological characteristics and prognosis in patients with a type 2 or 3 Brugada electrocardiogram pattern , Heart Rhythm , 5 , 11 , (1561) , (2008) .[doi.org]
  • Probst, Sodium channel blocker tests allow a clear distinction of electrophysiological characteristics and prognosis in patients with a type 2 or 3 Brugada electrocardiogram pattern, Heart Rhythm, 5, 11, (1561), (2008). KEVIN THOMAS and AUGUSTUS O.[doi.org]
  • People with acute atrial fibrillation who present with heart failure have a worse prognosis.[aafp.org]
  • Long-term prognosis of patients diagnoses with Brugada syndrome: Results from the FINGER Brugada Syndrome Registry. Circulation. 2010;121:635-643. Okamura H, Kamakura T, Morita H, Tokioka K, Nakajima I, Wada M, et al.[revcardiologia.sld.cu]
  • Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, et al. (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 311: 819–823. View Article Google Scholar 34.[doi.org]

Etiology

  • While many etiologies of AIN have been recognized, the majority (60-70 %) are due to allergic reactions or drug exposure. Many different classes of drugs and several agents within a class can cause drug induced AIN.[ncbi.nlm.nih.gov]
  • Rubin RL: Etiology and mechanisms of drug-induced lupus. Curr Opin Rheumatol 1999;11:357–363. Goldman AL, Enquist R: Hyperacute radiation pneumonitis. Chest 1975;67:613–615.[doi.org]
  • United Kingdom, 3 to 6 percent have atrial fibrillation, and about 40 percent were newly diagnosed. 2, 3 Among acute hospital admissions in New Zealand, 10 percent (95 percent confidence interval, 9 to 12 percent) had documented atrial fibrillation. 4 Etiology[aafp.org]
  • Completed Treatment Fascicular Block / Latency Period / Motor Activities / Postoperative pain 1 2 Completed Treatment Feeling Anxious / Pain NOS 1 2 Completed Treatment Healthy Volunteers 1 2 Completed Treatment Hemorrhoids 1 2 Completed Treatment Hip Pain Etiology[drugbank.ca]

Epidemiology

  • Nevertheless, we cannot assign any epidemiologic value to our report.[ncbi.nlm.nih.gov]
  • As such, the epidemiological value of the data is considered highly limited. Furthermore, pregnancy outcome in these reports may be confounded by the underlying fetal condition for which flecainide is administered.[medicinesinpregnancy.org]
  • ., Melissa Huther, Margit Scholz, Linda Stefan, and Surena Khatir; Program Office, Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Md.: Lawrence M.[doi.org]
  • The epidemiology of atrial fibrillation. In: Falk RH, Podrid P, eds. Atrial fibrillation: mechanisms and management. 2d ed. Philadelphia: Lippincott-Raven Publishers, 1997:1–22. ... 2. Lip GYH, Tean KN, Dunn FG.[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • This case reviews the pathophysiology and management of flecainide toxicity including novel strategies of IFE and ECMO.[ncbi.nlm.nih.gov]
  • Although the exact pathophysiologic explanation of this phenomenon remains unclear, it is well known that the susceptibility to severe flecainide toxicity is increased in patients with chronic kidney disease.[ncbi.nlm.nih.gov]
  • Useful For Suggests clinical disorders or settings where the test may be helpful Optimizing dosage Assessing toxicity Monitoring compliance Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory[mayocliniclabs.com]

Prevention

  • In the case of AVRT, flecainide exhibited a preventive effect on tachycardia induced by programmed electrical stimulation (PES). In the case of nsVT, flecainide markedly reduced the number of VPC and abolished the VT on the Holter ECG.[ncbi.nlm.nih.gov]
  • The aim of the present study was to test efficacy and safety of a combination of flecainide and metoprolol in preventing AF clinical recurrences.[ncbi.nlm.nih.gov]
  • […] class Ic antiarrhythmic agent used to prevent and treat tachyarrhythmias Tambocor Flecaine N-(2-Piperidinylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide CCRIS 313 ( -)-flecainide ( -)-Flecainide Flecainide Flecainida Flecainidum edit English flecainide[wikidata.org]
  • We recently found that the drug flecainide inhibits RyR2 channels and prevents CPVT in mice and humans.[ncbi.nlm.nih.gov]
  • These data are consistent with flecainide's known inhibition of Na channels to prevent triggered beats 16.[ncbi.nlm.nih.gov]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!