What are the potential side effects of Flecainide (antiarrhythmic medication)?

From the Guidelines

Flecainide can cause several potential side effects, including ventricular tachycardia, congestive heart failure, and enhanced AV nodal conduction, as noted in the acc/aha/esc guidelines for the management of patients with atrial fibrillation 1.

Potential Side Effects of Flecainide

The potential side effects of flecainide include:

• Ventricular tachycardia
• Congestive heart failure
• Enhanced AV nodal conduction, which can lead to conversion of atrial fibrillation to atrial flutter These side effects are more likely to occur in patients with structural heart disease or impaired kidney function, as noted in the guidelines for the management of patients with atrial fibrillation 1.

Serious Side Effects

More serious side effects that require immediate medical attention include:

• New or worsening heart rhythm problems
• Shortness of breath
• Chest pain
• Fainting
• Signs of heart failure, such as swelling in the ankles or feet It's essential to take flecainide exactly as prescribed and attend all follow-up appointments to monitor for potential complications, as recommended in the acc/aha/esc 2006 guidelines for the management of patients with atrial fibrillation 1.

Monitoring and Precautions

Regular ECG monitoring is recommended when initiating flecainide therapy, and precautions should be observed when using flecainide in patients with intraventricular conduction delay or left bundle branch block, as noted in the guidelines for the management of patients with atrial fibrillation 1.

Conclusion is not allowed, so the answer will continue without one.

The guidelines also recommend that flecainide should not be used in patients with coronary artery disease or reduced left ventricular ejection fraction (LVEF), as noted in the acc/aha/esc 2006 guidelines for the management of patients with atrial fibrillation 1.

Additional Considerations

Patients with structural heart disease or impaired kidney function may be at higher risk for serious side effects, and flecainide should be used with caution in these patients, as recommended in the guidelines for the management of patients with supraventricular arrhythmias 1.

From the FDA Drug Label

ADVERSE REACTIONS In post-myocardial infarction patients with asymptomatic PVCs and non-sustained ventricular tachycardia, flecainide therapy was found to be associated with a 5.1% rate of death and non-fatal cardiac arrest, compared with a 2.3% rate in a matched placebo group. New or worsened arrhythmias which occurred in 1% of 108 patients with PSVT and in 7% of 117 patients with PAF; and new or exacerbated ventricular arrhythmias which occurred in 7% of 1330 patients with PVCs, non-sustained or sustained VT New or worsened CHF occurred in 6.3% of 1046 patients with PVCs, non-sustained or sustained VT. The following additional adverse experiences, possibly related to flecainide therapy and occurring in 1% to less than 3% of patients, have been reported in acute and chronic studies: Body as a Whole: malaise, fever; Cardiovascular: tachycardia, sinus pause or arrest; Gastrointestinal: vomiting, diarrhea, dyspepsia, anorexia; Skin: rash; Visual: diplopia; Nervous System: hypoesthesia, paresthesia, paresis, ataxia, flushing, increased sweating, vertigo, syncope, somnolence, tinnitus; Psychiatric: anxiety, insomnia, depression

The potential side effects of Flecainide include:

• Cardiac effects: new or worsened arrhythmias, new or exacerbated ventricular arrhythmias, and non-fatal cardiac arrest
• Non-cardiac effects:
  • Common effects: dizziness, visual disturbances, dyspnea, headache, nausea, fatigue, palpitation, chest pain, asthenia, tremor, constipation, edema, abdominal pain
  • Less common effects: malaise, fever, tachycardia, sinus pause or arrest, vomiting, diarrhea, dyspepsia, anorexia, rash, diplopia, hypoesthesia, paresthesia, paresis, ataxia, flushing, increased sweating, vertigo, syncope, somnolence, tinnitus, anxiety, insomnia, depression 2

From the Research

Flecainide Side Effects

The potential side effects of Flecainide, an antiarrhythmic medication, can be categorized into cardiac and non-cardiac adverse effects.

• Cardiac side effects:
  • Proarrhythmic events, which can lead to life-threatening arrhythmias 3, 4, 5
  • Conduction abnormalities, such as sinus pauses or complete atrioventricular block 3, 6
  • Negative inotropic effects, which can worsen heart failure 3, 4
  • Cardiogenic shock, a rare but serious side effect 5
• Non-cardiac side effects:
  • Abnormal vision, dizziness, and headaches, which are often mild and transient 3, 4
  • Numbness, blurred vision, and ataxia, which can be more severe 6
  • Gastrointestinal symptoms, such as nausea and vomiting, although not commonly reported

Patient-Specific Considerations

The risk of side effects may vary depending on the patient population and underlying conditions.

• Patients with structural heart disease, such as coronary artery disease or left ventricular dysfunction, may be at higher risk of cardiac side effects 3, 6
• Patients with renal dysfunction may require careful monitoring and dose adjustment to avoid toxicity 4, 5
• Newborns with supraventricular tachycardia may be treated with flecainide, but require close monitoring for potential side effects 7

Treatment and Monitoring

To minimize the risk of side effects, careful patient selection, monitoring, and dose adjustment are essential.

• Regular electrocardiogram (ECG) monitoring and Holter monitoring can help detect potential cardiac side effects 3, 7, 6
• Serum flecainide levels should be monitored, especially in patients with renal dysfunction or those at risk of toxicity 5
• Patients should be educated on the potential side effects and instructed to seek medical attention if they experience any symptoms or concerns 4, 5