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Advanced Technical IVT

flecainide

Pronunciation: FLECK-ah-nyde

Class IC antiarrhythmic medication that blocks sodium channels, used primarily for atrial arrhythmias in patients without structural heart disease.

Full Definition

Flecainide is a class IC antiarrhythmic agent that blocks voltage-gated sodium channels, significantly slowing conduction velocity throughout the heart while having minimal effects on repolarization. The drug is highly effective for treating atrial fibrillation and atrial flutter, particularly in patients with normal ventricular function and no structural heart disease. However, flecainide is contraindicated in patients with coronary artery disease or heart failure due to increased mortality risk demonstrated in the Cardiac Arrhythmia Suppression Trial (CAST). The medication can also cause QRS widening and has negative inotropic effects. It is often used as a 'pill-in-the-pocket' approach for terminating acute episodes of atrial fibrillation.

Usage

Usage note: Contraindicated in structural heart disease; monitor QRS width during therapy.

In Context

  • "Flecainide was prescribed for paroxysmal atrial fibrillation after echocardiogram confirmed normal left ventricular function." — Cardiology clinic note
  • "The patient successfully used flecainide as pill-in-the-pocket therapy to terminate her atrial fibrillation episodes." — Follow-up visit documentation

Also known as

Tambocor

Don't confuse with

propafenone quinidine

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