PO-04-052 FLECAINIDE INDUCED WIDE COMPLEX TACHYCARDIA

Flecainide is a class IC antiarrhythmic that blocks cardiac sodium channels and used to treat variety of supraventricular tachyarrhythmias. has use dependent properties with greater effect at higher heart rates carries risk atrial flutter 1:1 AV conduction, Describing case wide complex tachycardia secondary flecainide use. N/A A 72-year-old female COPD, diabetes, history typical flutter, persistent fibrillation treated diltiazem called EMS when she awoke sudden onset dyspnea epigastric pain. found her diaphoretic, tachycardic, normotensive. EKG showed (WCT) rate 230 bpm. She received an amiodarone bolus but remained in WCT. In the ER, became hypotensive was electrically cardioverted sinus rhythm resolution hypotension. started on heparin drips. Troponin peaked 0.04 ng/mL. coronary angiogram no significant artery disease transthoracic echocardiogram ejection fraction 60-65% normal wall motion. However, prior reviewed demonstrated 2:1 conduction The WCT most likely due aberrancy. slows velocity myocardial tissue, increasing cycle length circuit, this can allow for flutter. also demonstrates properties, more blocking rates, cause QRS widening setting tachycardia. Although reported ventricular tachycardia, patient’s exactly same as so felt be were discontinued, amiodarone. Medications should possible after structural ischemic causes are ruled out. While not common WCT, organize into which could result aberrancy,