Atrial flutter with 1:1 conduction after administration of the antimalarial drug mefloquine.
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.
Fonteyne
W
W
Department of Cardiology, University Hospital Ghent, Belgium.
Bauwens
A
A
Jordaens
L
L
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
D000962:Antimalarials; D013015:Sotalol; D004074:Digitoxin; D015767:Mefloquine