Flecainide

Question 1

What is the drug class of Flecainide?

Answer 1

Class Ic anti-arrhythmic, sodium channel blocker

Question 2

What is the common indication for Flecainide?

Answer 2

Wide spectrum - supraventricular arrhythmias (fibrillations and flutter), premature ventricular contractions, Wolff-Parkinson-White syndrome

Question 3

What is the mechanism of action of Flecainide?

Answer 3

Blocks sodium channels in cardiac myocytes
Reduces phase 0, reduce automaticity (increase the threshold)
Increase the AP duration and increase the refractory period (especially in rapidly depolarising atrial tissue)

ECG - increase PR, QRS and QT

Oral or IV

Binds to channels in active or inactive state

Question 4

What are the common adverse reactions of Flecainide?

Answer 4

• Can be pro-arrhythmic and risk of sudden death in those with structural heart disease and chronic use of the drug
• Flecainide flutter (increase ventricular response) usually need to give a beta blocker along side to block the AVN
• CNS and GI effects

Question 5

What are the common drug-drug interactions of Flecainide?

Answer 5

• Other anti-arrhythmics - risk of bradycardia