Flecainide is a safe and effective treatment for pre-excited atrial fibrillation rapidly conducted to the ventricle in pregnant women: a case series

Samuel Chauveau; Olivier Le Vavasseur; Elodie Morel; Arnaud Dulac; Philippe Chevalier

doi:10.1093/ehjcr/ytz066

Flecainide is a safe and effective treatment for pre-excited atrial fibrillation rapidly conducted to the ventricle in pregnant women: a case series

Eur Heart J Case Rep. 2019 Jun 1;3(2):ytz066. doi: 10.1093/ehjcr/ytz066.

Authors

Samuel Chauveau^{1

2}, Olivier Le Vavasseur³, Elodie Morel², Arnaud Dulac¹, Philippe Chevalier^{1

2}

Affiliations

¹ Department of Rhythmology, Hospices Civils de Lyon, Louis Pradel Cardiovascular Hospital, 26 Avenue du Doyen jean Lépine, Lyon, France.
² Lyon Reference Center for Inherited Arrhythmias, Louis Pradel Cardiovascular Hospital, 28 avenue Doyen Lépine, Bron, France.
³ Department of Cardiology, Northwest Hospital, Gleizé, France Hospital, 39 Plateau d'Ouilly Gleizé, Gleize, France.

Abstract

Background: Pregnancy is associated with an increased incidence of cardiac arrhythmias likely due to hormonal, haemodynamic, and autonomic changes. Yet, there is little data available regarding the efficacy and safety of anti-arrhythmic agents to prevent pre-excited atrial fibrillation (AF) in pregnant women.

Case summary: We report on three pregnant women who developed AF rapidly conducted to the ventricle through an overt accessory pathway as the first manifestation of Wolff-Parkinson-White syndrome.

Discussion: All patients were treated with flecainide with neither arrhythmias recurrence nor adverse events of the treatment. Mechanisms of action and clinical efficacy of flecainide are discussed.

Keywords: Case series; Flecainide; Malignant arrhythmia; Pre-excited atrial fibrillation; Sudden cardiac death; Ventricular fibrillation; Wolff–Parkinson–White syndrome.