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Atrial flutter with 1:1 atrioventricular conduction caused by propafenone
1Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
Pacing and Clinical Electrophysiology : PACE
|October 30, 1998
Summary
Propafenone, a Class IC antiarrhythmic, can rarely cause 1:1 atrial flutter conduction. This uncommon side effect in patients with coronary disease necessitates careful monitoring for adverse cardiac events.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- Atrial flutter typically presents with 2:1 atrioventricular (AV) conduction, resulting in a ventricular rate of approximately 150 beats/min.
- Class IA antiarrhythmic drugs are known to potentially induce 1:1 AV conduction due to atrial rate reduction and vagolytic effects.
Observation:
- A case of 1:1 atrial flutter with a ventricular rate of 250 beats/min was observed in a patient with coronary disease receiving propafenone.
- This contrasts with the usual presentation of atrial flutter and the known effects of other antiarrhythmic drug classes.
Findings:
- Propafenone, a Class IC antiarrhythmic agent, demonstrated an unusual ability to facilitate 1:1 AV conduction.
- Unlike Class IA drugs, propafenone lacks anticholinergic properties, making this observed side effect particularly noteworthy.
Implications:
- The occurrence of 1:1 AV conduction with propafenone is an uncommon but significant adverse effect that clinicians must recognize.
- This finding underscores the importance of vigilant electrocardiographic monitoring in patients treated with propafenone, especially those with underlying cardiac conditions.