Class IC antiarrhythmic drugs, flecainide and pilsicainide, produce ST segment elevation simulating inferior myocardial ischemia.
Flecainide and pilsicainide, Class IC antiarrhythmic drugs with slow kinetics, were administered to a 64-year-old man experiencing ventricular tachycardia. Both drugs suppressed the arrhythmia, but caused ST segment elevation in leads II, III, and aVF. No evidence of ischemic heart disease was detected. Withdrawal of the drugs eliminated the ST change. Because these drugs frequently are used to treat tachyarrhythmias in patients who may present with chest pain, this rare ECG manifestation of Class IC drugs should be recognized to avoid misdiagnosis of acute inferior myocardial infarction.
Nakamura
W
W
The Third Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kamoda, Kawagoe, Japan.
Segawa
K
K
Ito
H
H
Tanaka
S
S
Yoshimoto
N
N
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005424:Flecainide / Q000009:adverse effects* / Q000627:therapeutic use; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide; D005424:Flecainide