Syncope in patients with atrial flutter during treatment with class Ic antiarrhythmic drugs

Kawabata, Mihoko; Hirao, Kazuyuki; Horikawa, Tomoe; Suzuki, Kou; Motokawa, Katsuhiko; Suzuki, Fumio; Azegami, Kouji; Hiejima, Kazumasa

doi:10.1054/jelc.2001.22034

Cited by 27 publications

(10 citation statements)

References 13 publications

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“…In particular, administration of class Ic antiarrhythmic agents has increased because of their high efficacy, although attention has also been focused on the induction of arrhythmias by these drugs. [1][2][3] We report here a case with pil-sicainide hydrochloride toxicity in which it was possible to clarify the correlation between the serial serum pilsicainide levels and serial electrocardiographic findings.…”

Section: In Recent Years Various Antiarrhythmic Drugs Have Been Devementioning

confidence: 99%

A Case of the Toxicity of Pilsicainide Hydrochloride With Comparison of the Serial Serum Pilsicainide Levels and Electrocardiographic Findings

et al. 2004

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SUMMARYWe treated an 88-year-old man with aortic valvular stenosis/insufficiency and paroxysmal atrial fibrillation, who developed ventricular tachycardia due to pilsicainide toxicity.He was treated at the outpatient clinic of his local hospital, and was administered pilsicainide (100 mg/day) for atrial fibrillation. The electrocardiographic findings on admission to our hospital indicated wide QRS with frequent episodes of ventricular tachycardia. We diagnosed him as having pilsicainide toxicity because of a low cardiac output and renal dysfunction. His creatinine level was 2.4 mg/dL and the serum pilsicainide level was 2.42 µg/mL on admission. Fluid infusion and continuous hemodiafiltration were performed to achieve an early reduction in the serum pilsicainide level. His serum pilsicainide concentration was significantly decreased by these treatments, and the prolongation of the QTc and ventricular tachycardia improved in parallel to the decrease in the serum pilsicainide level. The changes in the serum pilsicainide level showed a significant positive correlation with the changes in the electrocardiographic findings (PQ, QRS, ST intervals, and QTc).Pilsicainide should be administered with great care to elderly patients, especially patients with cardiac dysfunction and renal dysfunction. Estimation of the serum level may be possible from the electrocardiographic findings if the pilsicainide toxicity occurs.

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Section: In Recent Years Various Antiarrhythmic Drugs Have Been Devementioning

confidence: 99%

A Case of the Toxicity of Pilsicainide Hydrochloride With Comparison of the Serial Serum Pilsicainide Levels and Electrocardiographic Findings

et al. 2004

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“…However, although these drugs may prevent AF recurrences, AF can also be converted into AFl 51 52. Therefore, a combination with calcium channel blockers is recommended 53 54…”

Section: Management Of Af In Athletesmentioning

confidence: 99%

Atrial fibrillation and atrial flutter in athletes

et al. 2012

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Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, with an estimated prevalence of 0.4% to 1% in the general population, increasing with age to 8% in those above 80 years. The recognised risk factors for developing AF include age, structural heart disease, hypertension, diabetes mellitus or hyperthyroidism. However, the mechanisms underlying the initiation of AF in patients below 60 years of age, in whom no cardiovascular disease or any other known causal factor is present, remain to be clarified. This condition, termed as lone AF, may be responsible for as many as 30% of patients with paroxysmal AF seeking medical attention. Recent studies suggest that long-term endurance exercise may increase the incidence of AF and atrial flutter (AFl) in this population. This review article is intended to analyse the prevalence of AF and AFl, the pathophysiological mechanisms responsible for the association between endurance sport practice and AF or AFl and the recommended therapeutic options in endurance athletes.

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“…Particular caution should be exercised with the monotherapeutic use of class 1 antiarrhythmic drugs in AF patients. These drugs may prevent AF recurrences, but can also convert AF into slow atrial flutter, which may conduct oneto-one to the ventricles during situations of high sympathetic tone [41,42]. Class 1 drugs can be initiated for the prevention of AF episodes after adequate ventricular rate control during exercise has been assured.…”

Section: Management Of Af In Athletesmentioning

confidence: 99%

Prevalence, mechanism and management of atrial fibrillation in athletes

Calvo¹,

Mont²

2011

Cardiovasc Med

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SummaryAtrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice with an estimated prevalence of 0.4% to 1% in the general population [1], increasing with age to 8% in those older than 80 years [2]. The recognised risk factors for developing AF include age, structural heart disease, hypertension, diabetes mellitus and hyperthyroidism [3]. However, the mechanisms underlying the onset and maintenance of AF in patients younger than 60 years in whom no cardiovascular disease or any other known causal factor is present are yet to be clarified. This condition is termed lone AF [4], and may be responsible for as many as 30% of patients with paroxysmal AF seeking medical attention [5,6].It is well known that regular exercise is beneficial to health and reduces the risks of cardiovascular diseases [7,8]. However, recent studies suggest that longterm endurance exercise may increase the incidence of AF [9][10][11][12][13][14][15][16].This review article is intended to analyse the possible links between AF and endurance sport practice, the pathophysiological mechanisms responsible for this association and the recommended therapeutic options.

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Syncope in patients with atrial flutter during treatment with class Ic antiarrhythmic drugs

Cited by 27 publications

References 13 publications

A Case of the Toxicity of Pilsicainide Hydrochloride With Comparison of the Serial Serum Pilsicainide Levels and Electrocardiographic Findings

A Case of the Toxicity of Pilsicainide Hydrochloride With Comparison of the Serial Serum Pilsicainide Levels and Electrocardiographic Findings

Atrial fibrillation and atrial flutter in athletes

Prevalence, mechanism and management of atrial fibrillation in athletes

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