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Perioperative Management of Flecainide: A Problem-Based Learning Discussion.
Leah Acker1, Kristen Bova Campbell2, Colleen Naglee1,3
1From the Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina.
A&A Practice
|April 1, 2021
Summary
Flecainide, an antiarrhythmic drug, can cause rapid atrial flutter, especially during surgery. This review covers flecainide
Area of Science:
- Cardiology
- Pharmacology
Background:
- Flecainide is a widely prescribed first-line antiarrhythmic for atrial arrhythmias.
- Its use is increasing despite being an older medication.
- Flecainide is indicated for patients without coronary artery or structural heart disease.
Purpose of the Study:
- To review flecainide pharmacology.
- To describe arrhythmias associated with flecainide use.
- To provide recommendations for perioperative management of flecainide.
Main Methods:
- Literature review of flecainide pharmacology.
- Analysis of arrhythmogenic properties of flecainide.
- Development of perioperative management guidelines.
Main Results:
- Flecainide can induce rapid atrial flutter, leading to hemodynamic compromise.
- The perioperative period presents increased physiological stress, exacerbating risks.
- Specific arrhythmias linked to flecainide use are identified.
Conclusions:
- Perioperative management of flecainide requires careful consideration.
- Understanding flecainide's arrhythmogenic potential is crucial for patient safety.
- Recommendations are provided to mitigate risks associated with flecainide during surgery.