Failure of diltiazem to prevent 1:1 conduction of atrial flutter: a case report.
1:1 conduction
Atrial flutter
Case report
Class 1c
Diltiazem
Flecainide
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
18 Jul 2023
18 Jul 2023
Historique:
received:
25
06
2021
accepted:
24
04
2023
medline:
21
7
2023
pubmed:
19
7
2023
entrez:
18
7
2023
Statut:
epublish
Résumé
Atrial flutter with 1:1 conduction to the ventricles is a dangerous cardiac arrhythmia. Contemporary guidelines recommend atrioventricular nodal blocking agents should be co-administered with class 1C anti-arrhythmics, as prophylaxis against 1:1 flutter. No guidance is provided on the type or strength of atrioventricular nodal blockade required, and in practice, these agents are frequently prescribed at low dose, or even omitted, due to their side effect profile. A 62 year old Caucasian man with a history of paroxysmal atrial fibrillation treated with flecainide, presented with atrial flutter with 1:1 conduction to the ventricles and was cardioverted. Diltiazem was added to prevent this complication and he again presented with atrial flutter with 1:1 conduction to the ventricles, despite prophylaxis with coadministration of diltiazem. This case report demonstrates failure of diltiazem to prevent 1:1 flutter in a patient chronically treated with flecainide for paroxysmal atrial fibrillation.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial flutter with 1:1 conduction to the ventricles is a dangerous cardiac arrhythmia. Contemporary guidelines recommend atrioventricular nodal blocking agents should be co-administered with class 1C anti-arrhythmics, as prophylaxis against 1:1 flutter. No guidance is provided on the type or strength of atrioventricular nodal blockade required, and in practice, these agents are frequently prescribed at low dose, or even omitted, due to their side effect profile.
CASE PRESENTATION
METHODS
A 62 year old Caucasian man with a history of paroxysmal atrial fibrillation treated with flecainide, presented with atrial flutter with 1:1 conduction to the ventricles and was cardioverted. Diltiazem was added to prevent this complication and he again presented with atrial flutter with 1:1 conduction to the ventricles, despite prophylaxis with coadministration of diltiazem.
CONCLUSIONS
CONCLUSIONS
This case report demonstrates failure of diltiazem to prevent 1:1 flutter in a patient chronically treated with flecainide for paroxysmal atrial fibrillation.
Identifiants
pubmed: 37464369
doi: 10.1186/s13256-023-03947-5
pii: 10.1186/s13256-023-03947-5
pmc: PMC10355050
doi:
Substances chimiques
Diltiazem
EE92BBP03H
Flecainide
K94FTS1806
Anti-Arrhythmia Agents
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
319Informations de copyright
© 2023. The Author(s).
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