Hoffmann A, Wenk M, Follath F
Int J Cardiol. 1986 Jun;11(3):353-5. doi: 10.1016/0167-5273(86)90040-9.
A 32-year-old woman with prolapsed mitral valve was treated with flecainide because of an episode of primary ventricular fibrillation. The drug was chosen because several hundred short runs of ventricular tachycardia unrelated to exercise were observed during 24-hour monitoring. Oral medication at a dose of 200 mg twice daily suppressed all repetitive ventricular ectopy. Eighteen months later, however, a further 24-hour recording showed a ventricular arrhythmia which was provoked early in the morning by exercise. Because the tablets were taken late in the evening and early in the morning it was suspected that toxic levels of flecainide may have produced the arrhythmia. Measurement confirmed this suspicion. Reducing the dosage abolished the arrhythmia.
一名32岁二尖瓣脱垂女性因原发性心室颤动发作接受氟卡尼治疗。选择该药物是因为在24小时监测期间观察到数百次与运动无关的短阵室性心动过速。每日两次口服200毫克剂量的药物可抑制所有重复性室性早搏。然而，18个月后，进一步的24小时记录显示存在一种室性心律失常，清晨运动可诱发。由于片剂是在傍晚和清晨服用的，怀疑可能是氟卡尼的毒性水平导致了心律失常。测量结果证实了这一怀疑。减少剂量后心律失常消失。
