Anesth Pain Med.  2012 Jan;7(1):76-79.

Perimortem cesarean section in a pregnant woman with flecainide-induced ventricular tachycardia: A case report

• Lee JY
• Song E
• Suh JH
• Choi WJ
• Cho SK
• Han SM

Abstract

Flecainide is a drug used to manage supraventricular and ventricular arrhythmias. It is also effective in the treatment of fetal tachyarrhythmia through administration to the mother. However, flecainide toxicity may cause serious complications, including cardiac conduction disturbance, ventricular arrhythmia, resulting in syncope and sudden death. We describe here a 27-year-old woman at 31 weeks of gestation who experienced ventricular tachycardia, leading a perimortem cesarean section. On her past medication history, she has taken overdose of oral flecainide for the treatment of fetal atrial flutter. Just after neonatal delivery, her ventricular tachycardia was successfully reverted to a sinus rhythm through administration of intravenous lidocaine and hemodynamics were stabilized. According to her clinical signs and symptoms, we presume the ventricular tachycardia was likely induced by flecainide toxicity, although serum flecainide concentration could not be measured in our institution.

Keyword

Fetal atrial flutter; Flecainide; Perimortem cesarean section; Ventricular tachycardia

MeSH Terms

Adult
Arrhythmias, Cardiac
Atrial Flutter
Cesarean Section
Death, Sudden
Female
Flecainide
Hemodynamics
Humans
Lidocaine
Mothers
Pregnancy
Pregnant Women
Syncope
Tachycardia
Tachycardia, Ventricular
Flecainide
Lidocaine