A Case of Flecainide-Induced Hyponatremia

The complex classification for the diagnosis and treatment illustrates that hyponatremia is a very heterogeneous disorder. However, data on hyponatremia induced by flecainide, an often-prescribed antiarrhythmic agent, are scarce in the literature. A 78-year-old man with a recent history of recurrent hyponatremia and symptomatic paroxysmal atrial fibrillation presented with the complaints of dizziness and fatigue. During his repeated hospital admissions, the patient was treated with hypertonic saline, which temporarily improved serum sodium levels, but hyponatremia recurred without sustained clinical improvement. After discontinuation of the drug, the sodium levels remained stable. Doctors should be aware of not only the electrocardiographic changes associated with flecainide, but also the less-often found clinical manifestations linked with hyponatremia.