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