Key result
Flecainide treatment for atrial fibrillation can cause an under-recognised transformation of the rhythm into atrial flutter with rapid 1:1 conduction, as presented in four cases.
Why the study?
Does flecainide treatment for atrial fibrillation lead to atrial flutter with rapid 1:1 conduction?
Case Report (n=4)
Does flecainide treatment for atrial fibrillation lead to atrial flutter with rapid 1:1 conduction?
Flecainide treatment for atrial fibrillation carries an under-recognized risk of organizing the rhythm into atrial flutter with rapid 1:1 conduction, potentially causing cardiovascular compromise.
May precipitate 1:1 flutter in AF patients on flecainide; hypothesis-generating and should not yet change practice.
Flecainide can "organise" atrial fibrillation into atrial flutter with 1:1 conduction, leading to cardiovascular compromise. The treatment of atrial fibrillation in the emergency department is often complex and depends on several factors, including time of onset of atrial fibrillation and previously known cardiac disease. Current guidelines include flecainide as a possible treatment for chemical cardioversion and maintaining sinus rhythm in paroxysmal atrial fibrillation.1 2 An important, under-recognised complication of flecainide is the transformation of rhythm from atrial fibrillation to atrial flutter. We present four such cases.
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Taylor et al. (2010) conducted a case report in Atrial fibrillation (n=4). Flecainide was evaluated on Transformation of rhythm from atrial fibrillation to atrial flutter with 1:1 conduction. Flecainide treatment for atrial fibrillation can cause an under-recognised transformation of the rhythm into atrial flutter with rapid 1:1 conduction, as presented in four cases.
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