Yonsei Med J.  2006 Feb;47(1):152-154. 10.3349/ymj.2006.47.1.152.

A Case of Acute Ventricular Capture Threshold Rise Associated with Flecainide Acetate

• Kang TS
• Yoon YW
• Park S
• Hong BK
• Kim D
• Kwon HM
• Kim HS

• KMID: 1715888
• DOI: http://doi.org/10.3349/ymj.2006.47.1.152

Abstract

Antiarrhythmic agents may increase capture threshold, but this is rarely of clinical significance. Flecainide acetate, a class IC agent, is reported to have a significant effect on the myocardial capture threshold. In this presentation, we report the case of a 72-year-old male, with a previously implanted VVI pacemaker due to sick sinus syndrome, who was treated with flecainide acetate for paroxysmal atrial arrhythmia control. During the fifteenth day of treatment, an abrupt rise in the ventricular capture threshold with ventricular pacing failure was noted. The capture threshold decreased two days after discontinuation of flecainide acetate.

Keyword

Flecainide acetate; capture threshold; pacing failure

MeSH Terms

Ventricular Function/*drug effects
*Pacemaker, Artificial
Male
Humans
Flecainide/*adverse effects/therapeutic use
Electrocardiography
Atrial Flutter/drug therapy
Anti-Arrhythmia Agents/*adverse effects/therapeutic use
Aged
Action Potentials/*drug effects

Figure

• 

  Fig. 1 The ECG tracing on rehospitalization shows capture failure with wide QRS idioventricular rhythm of 43/min. The second, fourth, and sixth QRS complexes were sensed and made each pacing blip (initial settled ventricular rate was 60/min).

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  Fig. 2 Well captured beat after resetting of pacemaker capture threshold to 5 V at 0.8 ms pulse duration and discontinuation of flecainide.

Reference

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