title: Atrial flutter with 1:1 conduction after administration of the antimalarial drug mefloquine.
abstract: Antimalarial drugs are well known for their cardiovascular toxicity. Quinine, the most famous antimalarial agent, mostly causes bradycardia. Quinidine, its dextrorotatory isomer, may cause 1:1 atrioventricular (AV) conduction during atrial flutter. The newly developed drug mefloquine was reported to have fewer cardiac side effects. We describe a 63-year-old male patient with atrial flutter in whom mefloquine use was associated with 1:1 AV conduction, and who then responded to therapy with digoxin and sotalol. The patient had a history of palpitations. This case report emphasizes that mefloquine should be used with caution in patients with a history of palpitations or underlying heart disease.
authors.affiliation: Department of Cardiology, University Hospital Ghent, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Fonteyne
authors.forename: A
authors.initials: A
authors.lastname: Bauwens
authors.forename: L
authors.initials: L
authors.lastname: Jordaens
mesh_terms: D000962:Antimalarials / Q000009:adverse effects*; D001282:Atrial Flutter / Q000139:chemically induced* / Q000188:drug therapy; D004074:Digitoxin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006329:Heart Conduction System / Q000187:drug effects; D006801:Humans; D008288:Malaria / Q000517:prevention & control; D008297:Male; D015767:Mefloquine / Q000009:adverse effects*; D008875:Middle Aged; D013015:Sotalol / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D013015:Sotalol; D004074:Digitoxin; D015767:Mefloquine