Propafenone, a Class IC antiarrhythmic, can cause the uncommon but important side effect of 1:1 atrial flutter.
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May warrant caution with propafenone in coronary disease; single case leaves open true incidence of 1:1 flutter.
We describe a case of 1:1 atrial flutter in a patient with coronary disease taking propafenone. In atrial flutter, the atrial rate is usually about 300 beats/min with 2:1 AV conduction and a ventricular rate of 150 beats/min. Class IA antiarrhythmic drugs, especially quinidine and disopyramide, may cause 1:1 AV response because they reduce atrial rate and are vagolytic. However, propafenone is a Class IC agent and has no anticholinergic properties, and the occurrence of 1:1 AV conduction at a rate of about 250 beats/min is an important side effect that, although uncommon, should be recognized.
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EL‐HARARI et al. (1998) studied this question.
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