Key result
Perioperative flecainide may predispose patients to rapid atrial flutter and resultant hemodynamic compromise.
Why the study?
Despite frequent use, flecainide may predispose patients to rapid atrial flutter with hemodynamic compromise, particularly during the physiologically stressful perioperative period.
Flecainide use in the perioperative period requires careful management due to the risk of rapid atrial flutter and hemodynamic compromise.
Alerts to hemodynamic risks with perioperative flecainide; leaves open optimal antiarrhythmic selection pending prospective trials.
Flecainide is a first-line antiarrhythmic drug used to treat atrial arrhythmias and/or supraventricular tachycardia in those without coronary artery disease or structural heart disease. Even though it is an older antiarrhythmic, flecainide accounted for 1.6 million prescriptions in the United States in 2016, and its utilization is generally increasing. Despite its popularity, flecainide may predispose patients to rapid atrial flutter with resultant hemodynamic compromise, particularly in the physiologically stressful perioperative period. This article reviews the pharmacology of flecainide, describes problematic arrhythmias that may arise specifically during flecainide use, and offers recommendations for perioperative flecainide management.
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Acker et al. (2021) conducted a review in Atrial arrhythmias and/or supraventricular tachycardia. Flecainide was evaluated. Flecainide use in the perioperative period may predispose patients to rapid atrial flutter with resultant hemodynamic compromise, despite its popularity as a first-line antiarrhythmic.
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