Wide Complex Tachycardia and Flecainide: A Dangerous Couple

Marco Bergonti; Ciro Ascione; Claudio Tondo; Andrea Sarkozy

doi:10.1016/j.jaccas.2021.06.019

Wide Complex Tachycardia and Flecainide: A Dangerous Couple

JACC Case Rep. 2021 Sep 1;3(11):1373-1375. doi: 10.1016/j.jaccas.2021.06.019.

Authors

Marco Bergonti^{1

2

3}, Ciro Ascione^{1

2}, Claudio Tondo^{3

4}, Andrea Sarkozy^{2

5}

Affiliations

¹ University of Milan, Cardiovascular Disease Fellowship Program, Milan, Italy.
² Department of Cardiology, University Hospital Antwerp, Edegem, Belgium.
³ Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy.
⁴ Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milano, Italy.
⁵ Cardiovascular Research, University of Antwerp, Antwerp, Belgium.

Abstract

Differential diagnosis of wide complex tachycardia in patients taking anti-arrhythmic can be challenging. Conventional ECG diagnostic criteria are poorly specific and should be applied with caution. Patients who develop life-threatening arrhythmias after flecainide infusion should be screened for Brugada Syndrome, especially if concomitant sinus node dysfunction is present. (Level of Difficulty: Intermediate.).

Keywords: AF, atrial fibrillation; CL, cycle length; ECG; ECG, electrocardiogram; FLA, atrial flutter; RBBB, right bundle branch block; VT, ventricular tachycardia; atrial fibrillation; flecainide toxicity; ventricular tachycardia; wide complex tachycardia.