title: His-Purkinje system reentry as a proarrhythmic effect of flecainide.
abstract: We report a case of tachycardia due to reentry within the His-Purkinje system (HPS) occurring after introduction of flecainide. The patient presented with a mild mitral regurgitation and normal left ventricular function. He had incomplete left bundle branch block with left-axis deviation. At the electrophysiology study, a prolonged HV interval was observed at baseline, and the tachycardia could be reproduced after ajmaline infusion. Six months after interruption of flecainide, the patient remains free of arrhythmia recurrence. The authors emphasize that proarrhythmic effects of flecainide may include reentry within the HPS in patients with underlying HPS disease.
authors.affiliation: Service de Cardiologie, Hôpital Sainte-Marguerite, CHU Marseille, France.
authors.forename: T
authors.initials: T
authors.lastname: Chalvidan
authors.forename: G
authors.initials: G
authors.lastname: Cellarier
authors.forename: J C
authors.initials: JC
authors.lastname: Deharo
authors.forename: R
authors.initials: R
authors.lastname: Colin
authors.forename: N
authors.initials: N
authors.lastname: Savon
authors.forename: N
authors.initials: N
authors.lastname: Barra
authors.forename: J P
authors.initials: JP
authors.lastname: Peyre
authors.forename: P
authors.initials: P
authors.lastname: Djiane
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000404:Ajmaline / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002036:Bundle of His / Q000187:drug effects / Q000503:physiopathology*; D002037:Bundle-Branch Block / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005424:Flecainide / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D011690:Purkinje Fibers / Q000187:drug effects / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents; D000404:Ajmaline; D005424:Flecainide