Vaquer Guiem, Marfil Laura, Ortega Josep, Sabaté-Rotés Anna, Gran-Ipiña Ferran, Roses-Noguer Ferran
Department of Pediatrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Department of Pediatrics, Hospital Universitari de Lleida, Lleida, Spain.
Ann Pediatr Cardiol. 2020 Jul-Sep;13(3):264-266. doi: 10.4103/apc.APC_116_19. Epub 2020 Jun 29.
Flecainide is a class IC antiarrhythmic indicated for ventricular and supraventricular arrhythmias in pediatric patients without structural heart disease. Flecainide has a narrow therapeutic window and proarrhythmic effect even in therapeutic doses and could lead to a life-threatening intoxication. Dosage errors, accidental intakes, and drug or food interactions, especially with dairy products, can be the cause of the intoxication. We report three consecutive cases of flecainide intoxication in children with supraventricular tachycardia (SVT) in our hospital from 2017 to 2019. Two cases had complete and spontaneous normalization of electrocardiogram (ECG) after flecainide removal. However, admission to the intensive care was required due to a sustained ventricular tachycardia in one case. Flecainide intoxication can be a life-threatening complication in patients with SVT. We believe all children should have close monitoring with serial ECG and plasma levels of flecainide during the 48-72 h after initiation of treatment, and consider hospitalization for patients <1 year of age.
氟卡尼是一种IC类抗心律失常药物，适用于无结构性心脏病的儿科患者的室性和室上性心律失常。氟卡尼的治疗窗较窄，即使在治疗剂量下也有促心律失常作用，可能导致危及生命的中毒。剂量错误、意外摄入以及药物或食物相互作用，尤其是与乳制品的相互作用，可能是中毒的原因。我们报告了2017年至2019年我院连续3例室上性心动过速（SVT）患儿发生氟卡尼中毒的病例。2例在停用氟卡尼后心电图（ECG）完全自发恢复正常。然而，有1例因持续性室性心动过速需要入住重症监护病房。氟卡尼中毒在SVT患者中可能是一种危及生命的并发症。我们认为，所有儿童在开始治疗后的48 - 72小时内应密切监测系列ECG和氟卡尼血浆水平，对于<1岁的患者应考虑住院治疗。
