Kawabata M, Hirao K, Horikawa T, Suzuki K, Motokawa K, Suzuki F, Azegami K, Hiejima K
First Department of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
J Electrocardiol. 2001 Jan;34(1):65-72. doi: 10.1054/jelc.2001.22034.
We describe 2 atrial flutter (AFL) patients with syncope during treatment with class Ic antiarrhythmic drugs. During the syncope, 1:1 atrioventricular (AV) conduction during AFL preceded a wide QRS tachycardia. The class Ic drugs, flecainide and pilsicainide, slowed the atrial rate, resulting in AFL with 1:1 AV conduction, and the width of the QRS complexes became wider during the tachycardia. Syncope was abolished after successful radiofrequency catheter ablation of the AFL. These potential proarrhythmic effects of the class Ic drugs should be taken into account in AFL patients, and concomitant use of beta-blocking agents would be critical to prevent proarrhythmias.
我们描述了2例在使用Ic类抗心律失常药物治疗期间出现晕厥的心房扑动（AFL）患者。在晕厥期间，AFL时的1:1房室（AV）传导先于宽QRS心动过速出现。Ic类药物氟卡尼和吡西卡尼减慢了心房率，导致AFL伴1:1 AV传导，且心动过速期间QRS波群宽度变宽。成功进行AFL的射频导管消融术后晕厥消失。Ic类药物的这些潜在促心律失常作用在AFL患者中应予以考虑，同时使用β受体阻滞剂对于预防心律失常至关重要。
