This case highlights the exceptional occurrence of flecainide-induced QTc prolongation and torsades de pointes without concurrent triggers.
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Warrants QTc vigilance with flecainide even without typical triggers; single case leaves open incidence and predictors.
This case report describes a 68-year-old woman presenting with flecainide induced syncope due to torsades de pointes (TP) ventricular tachycardia. Before TP onset, the QTc interval reached 680 ms without changes in QRS duration. None of the usual triggers were found. Prolongation of QT under flecaïnide is exceptional and the occurrence of TP without concurrent triggers has not been reported in the literature.
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Thévenin et al. (2003) studied this question.
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