Open AccessWide Complex Tachycardia in the Presence of Class I Antiarrhythmic Agents: A Diagnostic Challenge
Author(s) -
Bhardwaj Bhaskar,
Lazzara Ralph,
Stavrakis Stavros
Publication year - 2014
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12099
Subject(s) - medicine , atrial flutter , cardiology , tachycardia , atrial fibrillation , antiarrhythmic agent , concomitant , atrial tachycardia , fibrillation , anesthesia , heart disease , catheter ablation
We present two patients with paroxysmal atrial fibrillation on class 1C antiarrhythmic drugs without concomitant atrioventricular (AV) nodal blocking agents who developed atrial flutter with 1:1 AV conduction. Their electrocardiogram revealed wide complex tachycardia with rates >200/minute. Atrial flutter with 1:1 conduction in the presence of class IC antiarrhythmic drugs may present a diagnostic challenge. These cases illustrate the importance of coadministering an AV nodal blocking agent with class IC antiarrhythmic agents in patients with atrial fibrillation. The differential diagnosis of wide complex tachycardia in patients taking class IC agents should include atrial flutter with 1:1 AV conduction.