His-Purkinje system reentry as a proarrhythmic effect of flecainide

Pacing Clin Electrophysiol. 2000 Apr;23(4 Pt 1):530-3. doi: 10.1111/j.1540-8159.2000.tb00841.x.

Abstract

We report a case of tachycardia due to reentry within the His-Purkinje system (HPS) occurring after introduction of flecainide. The patient presented with a mild mitral regurgitation and normal left ventricular function. He had incomplete left bundle branch block with left-axis deviation. At the electrophysiology study, a prolonged HV interval was observed at baseline, and the tachycardia could be reproduced after ajmaline infusion. Six months after interruption of flecainide, the patient remains free of arrhythmia recurrence. The authors emphasize that proarrhythmic effects of flecainide may include reentry within the HPS in patients with underlying HPS disease.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Ajmaline / administration & dosage
  • Anti-Arrhythmia Agents / administration & dosage
  • Anti-Arrhythmia Agents / adverse effects*
  • Bundle of His / drug effects
  • Bundle of His / physiopathology*
  • Bundle-Branch Block / chemically induced*
  • Bundle-Branch Block / drug therapy
  • Bundle-Branch Block / physiopathology
  • Electrocardiography / drug effects
  • Female
  • Flecainide / administration & dosage
  • Flecainide / adverse effects*
  • Humans
  • Infusions, Intravenous
  • Purkinje Fibers / drug effects
  • Purkinje Fibers / physiopathology*
  • Tachycardia, Ventricular / drug therapy
  • Tachycardia, Ventricular / physiopathology

Substances

  • Anti-Arrhythmia Agents
  • Ajmaline
  • Flecainide