[Atrial flutter with 1:1 AV conduction during intravenous flecainide treatment].

Abstract

Acute drug treatment of recent onset atrial flutter may reduce the ventricular rate by increasing block in the A-V node (digitalis/verapamil) or act by directly affecting the atria by reducing the atrial rate or converting flutter to sinus rhythm (1a and 1c antiarrthythmic drugs). Treatment that reduces the atrial rate may cause 1:1 A-V conduction. Quinidine and disopyramide are well known for increasing A-V conduction to 1:1 in some patients, because of their anticholinergic effect on the A-V node. Flecainide, a 1c antiarrhythmic drug, slows down atrial conduction, reducing flutter rate by 1/3. Clinical studies have shown flecainide to be effective in converting atrial fibrillation, atrial tachycardia, A-V reentry and A-V nodal reentry tachycardias to sinus rhythm. The effect on atrial flutter has been less impressive. Flecainide prolongs A-V conduction and increases Wenckebach cycle length. In spite of this, 1:1 A-V conduction may occur during treatment with intravenous flecainide for atrial flutter. We present a case where this is demonstrated and review the literature.

• Authors: M Heldal, O M Orning
• Journal: Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke (Tidsskr Nor Laegeforen) Vol. 109 Issue 23 Pg. 2309-10 (Aug 20 1989) ISSN: 0029-2001 [Print] Norway
• Vernacular Title: Atrieflutter med 1:1 AV-overledning under intravenøs flekainidbehandling.
• PMID: 2505404 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Flecainide

Topics

• Aged
• Atrial Flutter (chemically induced, physiopathology)
• Electrocardiography
• Flecainide (administration & dosage, adverse effects)
• Humans
• Injections, Intravenous
• Male