Successful use of an intravenous infusion of flecainide and amiodarone for a refractory combination of postoperative junctional and ectopic tachycardias.
After repair of an atrioventricular septal defect with common atrioventricular junction in a 2-month-old girl, rapid atrial tachycardia, in combination with junctional ectopic tachycardia, led to severe postoperative cardiovascular compromise. Intercurrent runs of ectopic atrial tachycardia made atrial pacing impossible, despite high doses of intravenous amiodarone. Following the addition of flecainide to the infusion, we were able to control the rhythm, and when combined with atrial pacing, this led to an immediate haemodynamic improvement. Treatment of refractory supraventricular tachycardias with amiodarone combined with flecainide can be very effective in the setting of postoperative cardiac intensive care.
Haas
Nikolaus A
NA
Department of Paediatric Intensive Care, The Prince Charles Hospital, Brisbane, Australia. Nikolaus_Haas@health.qld.gov.au
Fox
Scott
S
Skinner
Jonathan R
JR
D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005424:Flecainide / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D011183:Postoperative Complications; D013612:Tachycardia, Ectopic Atrial / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013613:Tachycardia, Ectopic Junctional / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents; D005424:Flecainide; D000638:Amiodarone