氟卡尼诱发的伴有1:1房室传导的心房扑动的起搏器检测失败

Failed Pacemaker Detection of Flecainide-Induced Atrial Flutter With One-to-One Atrioventricular Conduction.

作者信息

Wurtz Paul J, Pearman Joseph, Bush Kelvin N V

机构信息

Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.

Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.

出版信息

JACC Case Rep. 2025 May 21;30(11):103365. doi: 10.1016/j.jaccas.2025.103365. Epub 2025 Apr 23.

BACKGROUND

Antiarrhythmic drugs commonly used in atrial fibrillation management are associated with variable clinical responses and proarrhythmic properties.

CASE SUMMARY

A 53-year-old woman presented with a wide-complex tachycardia. Electrocardiogram after amiodarone administration revealed a flecainide-induced atrial flutter with 1:1 AV conduction and pacemaker interrogation revealed undersensing of presenting ventricular rates at 230 beats/min.

DISCUSSION

Flecainide therapy has been well-described to organize AF into AFL that is predisposed to 1:1 AV conduction. This case underscores a concerning limitation in the detection of potentially life-threatening arrhythmias with some nominal pacemaker devices.