Key result
Flecainide induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff-Parkinson-White syndrome via uneven depression of accessory pathway conduction.
Case Report
This report describes a novel proarrhythmic effect of flecainide in WPW syndrome, causing incessant AVRT through uneven depression of accessory pathway conduction.
During orthodromic atrioventricular reentrant tachycardia (AVRT), ventricles are activated anterogradely through the atrioventricular node and retrogradely through an accessory pathway (AP). Antiarrhythmic drugs are initially used to prevent recurrences1,2 of AVRT, whereas catheter ablation is frequently performed as a definitive treatment.3 Occasionally, catheter ablation can be “proarrhythmic” if the AP is partially damaged but not completely eliminated.4 A similar proarrhythmic effect has not been described with antiarrhythmic drugs in patients with an AP.
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Pellizzón et al. (2016) conducted a case report in Wolff-Parkinson-White syndrome. Flecainide was evaluated. Flecainide induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff-Parkinson-White syndrome via uneven depression of accessory pathway conduction.
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