[Value of intravenous flecainide in electro-induced supraventricular arrhythmia. Apropos of 37 cases]

Thirty-seven patients presenting with electro-induced supraventricular arrhythmia sustained for more than 10 min or symptomatic received an intravenous injection of flecainide acetate (1.5 mg/kg; 10 mg/min). There were 24 cases of atrial fibrillation, 13 of atrial tachysystole with more than 180 beats per minute. Electrophysiological exploration was carried out for syncope (13 cases), lipothymia with palpitations (11 cases) or without palpitations (8 cases), or for a stroke of unknown origin. The induced arrhythmia was the only electrophysiological abnormality in 57% of cases. A return of sinus rhythm was obtained in 70% of cases during the injection (12 cases) or shortly after the end of the injection (14 patients). Safety was good, with the exception of the onset of two junctional rhythms and one case of non-syncopal monomorphic ventricular tachycardia. After an initial reduction, the PR, QRS, PA and HV intervals were significantly longer than baseline, whereas the AH space and the systolic blood pressure remained virtually unchanged. Thus the provision of IV flecainide acetate can only be beneficial in carrying out study protocols of abnormalities of the atrial substrate.