Flecainide, a widely prescribed class IC agent used to treat atrial arrhythmias, can in rare cases cause 1:1 atrial flutter with rapid conduction. We describe the case of a 59-year-old man who was on a maintenance regimen of flecainide for refractory atrial fibrillation. When 1:1 atrial flutter with rapid conduction developed, emergency medical technicians attempted synchronized cardioversion, which caused ventricular fibrillation necessitating defibrillation. The patient ultimately underwent radiofrequency ablation and cryoablation to resolve his symptomatic atrial flutter. We discuss the atrial proarrhythmic effects of flecainide and how to mitigate complications in high-risk patients.

氟卡尼是一种广泛用于治疗房性心律失常的 IC 类药物，在极少数情况下可引起 1:1 的快速传导的心房扑动。我们描述了一名 59 岁男性的病例，他正在接受氟卡尼维持治疗难治性心房颤动。当出现快速传导的 1:1 心房扑动时，急诊医疗技术人员尝试同步复律，导致心室颤动，需要除颤。患者最终接受了射频消融和冷冻消融，以解决有症状的心房扑动。我们讨论了氟卡尼的心房促心律失常作用以及如何减轻高危患者的并发症。