JACC. Case reports · 2025
Failed Pacemaker Detection of Flecainide-Induced Atrial Flutter With One-to-One Atrioventricular Conduction.
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Wurtz Paul J, Pearman Joseph, Bush Kelvin N V
Аннотация
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.
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.