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Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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 minute.
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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...

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Implantation of Total Artificial Heart in Congenital Heart Disease
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Flecainide Toxicity Leading to Transient Heart Failure With Reduced Ejection Fraction: A Case Study.

Trevor Wolchover1, Leili Pourafkari2, Vishva Dev2

  • 1Internal Medicine, Los Robles Regional Medical Center, Thousand Oaks, USA.

Cureus
|June 16, 2025
PubMed
Summary

Flecainide can cause reversible heart failure with reduced ejection fraction (HFrEF), even in patients without heart disease. Vigilance for cardiotoxicity is crucial, especially with changing renal function.

Keywords:
antiarrhythmic drugcardiologycardiology imagingechocardiogram (echo)electrocardiogram (ecg/ekg)flecainideheart failure and medical educationheart failure with reduced ejection fraction

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Flecainide is a Class Ic antiarrhythmic drug used for cardiac arrhythmias.
  • Limited evidence suggests a link between flecainide and heart failure with reduced ejection fraction (HFrEF).

Observation:

  • This case report details a patient who developed significant HFrEF attributed to flecainide.
  • The patient had no pre-existing structural heart disease.

Findings:

  • Flecainide-induced HFrEF was observed, potentially due to sodium channel blockade causing QRS prolongation and impaired conduction.
  • Transient renal dysfunction may exacerbate flecainide cardiotoxicity.

Implications:

  • Clinicians should monitor for flecainide cardiotoxicity, particularly in patients with fluctuating renal function.
  • This highlights the need for caution even when traditional contraindications for flecainide are absent.