Class IC antiarrhythmic drugs like flecainide and pilsicainide can cause reversible ST segment elevation in inferior leads, which should be recognized to avoid misdiagnosis of acute inferior myocardial infarction.
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Reversible inferior ST elevation with flecainide/pilsicainide may mimic infarction; single case report leaves open incidence and recognition needs.
Flecainide and pilsicainide, Class IC antiarrhythmic drugs with slow kinetics, were administered to a 64-year-old man experiencing ventricular tachycardia. Both drugs suppressed the arrhythmia, but caused ST segment elevation in leads II, III, and aVF. No evidence of ischemic heart disease was detected. Withdrawal of the drugs eliminated the ST change. Because these drugs frequently are used to treat tachyarrhythmias in patients who may present with chest pain, this rare ECG manifestation of Class IC drugs should be recognized to avoid misdiagnosis of acute inferior myocardial infarction.
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NAKAMURA et al. (1998) studied this question.
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