Pseudo infarction ECG pattern occurring during intravenous treatment with flecainide acetate
K J van Aubel1, J H Ruiter, A E Arnold
1Department of Cardiology, Medical Centre Alkmaar, The Netherlands.
European Heart Journal
|January 1, 1992
Summary
Flecainide acetate can cause significant electrocardiogram changes, mimicking myocardial infarction. These changes, including QRS widening and ST elevation, occurred in a patient despite ruling out acute myocardial infarction.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- Atrial flutter and anginal symptoms require effective treatment.
- Standard antiarrhythmic and rate-control medications like digoxin and verapamil may not always be effective.
Observation:
- A 79-year-old woman with atrial flutter and angina experienced symptom relief with nitroglycerin.
- Intravenous flecainide acetate administration was halted due to significant QRS duration increase and ST elevation in leads V1-V4.
- These electrocardiogram (ECG) abnormalities mimicked acute myocardial infarction but were confirmed not to be.
- Comparable ECG changes recurred upon a second administration of intravenous flecainide acetate.
Findings:
- Flecainide acetate can induce marked electrocardiogram abnormalities.
- These flecainide-induced ECG changes can closely resemble those of acute myocardial infarction.
- The observed ECG changes are reproducible with repeated flecainide administration.
Implications:
- Clinicians should be aware of flecainide acetate's potential to cause significant, misleading ECG changes.
- Distinguishing flecainide-induced ECG abnormalities from acute myocardial infarction is crucial for patient management.
- Careful monitoring during flecainide administration is essential, especially in patients with cardiac conditions.
Related Concept Videos
01:29Electrocardiogram
9.9K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
9.9K
01:29Disturbances in Heart Rhythm
5.5K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
5.5K
01:30Cardiac Action Potential
11.9K
Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
11.9K
01:28Electrocardiogram Fundamentals
2.2K
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
2.2K
01:29Dysrhythmias III: Characteristics of Dysrhythmias
711
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
711
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
1.2K
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
1.2K