Alraee Abdulrahman K, Chachar Tarique S, Shaaban Ammar S, Noor Husam A
Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR.
Cardiothoracic Surgery, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR.
Cureus. 2024 Nov 14;16(11):e73683. doi: 10.7759/cureus.73683. eCollection 2024 Nov.
Flecainide acetate is classified as a class IC antiarrhythmic medication according to the Vaughan-Williams classification, primarily used to manage both ventricular and supraventricular tachycardia. It is commonly employed for pharmacological cardioversion of atrial fibrillation (AF) and is frequently used in the "pill-in-the-pocket" approach for on-demand rhythm control. Despite its efficacy, flecainide is associated with significant adverse effects, including cardiac arrest, dysrhythmias, and heart failure. The presence of renal impairment or drug-drug interactions can exacerbate these side effects. Although rare, the risk of cardiogenic shock in flecainide toxicity is noteworthy. Given the potential for life-threatening hemodynamic compromise, often manifesting as ventricular arrhythmias like ventricular tachycardia or ventricular fibrillation, emergency physicians should maintain a high index of suspicion for flecainide toxicity in patients using the drug. Early recognition is crucial, as delayed diagnosis and treatment can be fatal. This report presents a case of an elderly female patient who presented with wide QRS complex tachycardia and hyponatremia. Her baseline rhythm was restored without the need for cardioversion, defibrillation, or pacing following the administration of sodium bicarbonate.
根据 Vaughan-Williams 分类法，醋酸氟卡尼被归类为 IC 类抗心律失常药物，主要用于治疗室性和室上性心动过速。它常用于心房颤动（AF）的药物复律，并且经常用于按需节律控制的“口袋药”方法。尽管氟卡尼有效，但它与严重的不良反应有关，包括心脏骤停、心律失常和心力衰竭。肾功能损害或药物相互作用的存在会加剧这些副作用。虽然罕见，但氟卡尼毒性导致心源性休克的风险值得注意。鉴于存在危及生命的血流动力学损害的可能性，通常表现为室性心律失常，如室性心动过速或心室颤动，急诊医生应对使用该药物的患者保持高度的氟卡尼毒性怀疑指数。早期识别至关重要，因为延迟诊断和治疗可能是致命的。本报告介绍了一例老年女性患者，她出现宽 QRS 波群心动过速和低钠血症。在给予碳酸氢钠后，她的基础节律得以恢复，无需进行复律、除颤或起搏。
