Question 81#

Which of the following statements regarding flecainide as a treatment of AFib is true?

A. It may contribute to an increase in the digoxin level
B. It may be used without an AV nodal blocking agent because of its potent effect on the AV conduction system
C. It has been shown to be effective and safe for use in patients with hypertrophic cardiomyopathy
D. It has no effect on the acute conversion of AFib but only on maintenance of sinus rhythm postcardioversion
E. It is used for the treatment of AFib but not atrial flutter

Correct Answer is A


It may contribute to an increase in the digoxin level. Flecainide (amiodarone, propafenone [Rythmol], and verapamil) can increase digoxin level. Flecainide can regularize and slow the atrial rhythm in patients with AFib and can, therefore, lead to increased ventricular response because of improved conduction of the atrial impulses through the AV node. It is, therefore, important to use an AV nodal blocking agent in patients with AFib treated with flecainide. It is used for AFib as well as flutter; however, it needs to be used with caution in atrial flutter patients, as it may slow the cycle length of the flutter circuit and result in more rapid conduction to the ventricle. There are no definite data on its safety in patients with hypertrophic cardiomyopathy. It is effective for acute conversion as well as maintenance of NSR postconversion.