Cardiologia (Rome, Italy)
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Cardiologia (Rome, Italy) · Mar 1990
Case ReportsOpposite effects of propafenone and flecainide in a patient with reciprocating supraventricular tachycardia.
A 46 year-old woman with Wolff-Parkinson-White syndrome (postero-septal accessory pathway), symptomatic for recurrent episodes of nonsustained paroxismal supraventricular tachycardia (PSVT), was empirically treated with propafenone (600 mg/day). After a week of therapy the patient returned to the hospital after an episode of syncope. She referred a significant increase in duration and frequency of "palpitations". ⋯ The patient has been asymptomatic on chronic oral therapy with flecainide during a follow-up period of 8 months. This case shows that 2 1c class antiarrhythmic drugs may have opposite effects (proarrhythmic and antiarrhythmic). Failure, or even the proarrhythmic effect of one drug, does not necessarily exclude the efficacy of another drug of the same subclass in preventing recurrence of PSVT.