Successful treatment of arrhythmia with β-blocker and flecainide combination in pregnant patients with Andersen-Tawil syndrome: A case report and literature review

Ann Noninvasive Electrocardiol. 2021 May;26(3):e12798. doi: 10.1111/anec.12798. Epub 2020 Sep 21.

Abstract

Andersen-Tawil syndrome (ATS) is a rare disorder characterized by a triad of ventricular arrhythmia (VA), dysmorphic features, and periodic paralysis. Due to the rarity of this condition, less is known about physiologic effect of pregnancy to ATS and arrhythmia. There is no established guideline for peripartum or postpartum treatment and prevention of arrhythmia in ATS; thus, the clinical management is challenging. We reported two KCNJ2-associated ATS patients who got pregnant and underwent vaginal birth safely. Both individuals had VA, micrognathia without periodic paralysis. β-blocker plus flecainide could be an effective treatment combination when monotherapy failed to control arrhythmia. VA of two pregnant patients with ATS could be controlled by either physiologic changes associated pregnancy or the combination treatment of β-blocker and flecainide.

Keywords: Andersen-Tawil syndrome; case report; flecainide; pregnancy; β-blocker.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Andersen Syndrome / drug therapy*
  • Anti-Arrhythmia Agents / therapeutic use*
  • Female
  • Flecainide / therapeutic use*
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Tachycardia, Ventricular / drug therapy*
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Anti-Arrhythmia Agents
  • Flecainide