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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244634 | PMC |
| http://dx.doi.org/10.1016/j.hrcr.2020.02.001 | DOI Listing |
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Acquired Type 1 Brugada Syndrome Induced by Chronic High-Dose Kratom Use.
Cureus
October 2024
Department of Emergency Medicine, Memorial Healthcare System, Hollywood, USA.
Article Synopsis
- Kratom, a natural substance used for chronic pain and opioid withdrawal, has been linked to serious heart conditions, particularly Brugada syndrome.
- A 36-year-old male with a history of substance abuse and underlying health conditions experienced chest pain, lightheadedness, and palpitations after using high doses of kratom for three years.
- His case revealed a type 1 Brugada pattern on an EKG, leading to the diagnosis of Brugada syndrome as a result of chronic kratom use, emphasizing the need for medical professionals to be aware of the potential severe cardiac risks associated with kratom.
Flecainide acetate is classified as a class IC antiarrhythmic medication according to the Vaughan-Williams classification, primarily used to manage both ventricular and supraventricular tachycardia. It is commonly employed for pharmacological cardioversion of atrial fibrillation (AF) and is frequently used in the "pill-in-the-pocket" approach for on-demand rhythm control. Despite its efficacy, flecainide is associated with significant adverse effects, including cardiac arrest, dysrhythmias, and heart failure.
View Article and Find Full Text PDFPrevalence and relevance of H558R in the efficacy and toxicity of flecainide in patients with atrial fibrillation: a cohort study.
Heart
November 2024
Cardiology, Hospital Clínico Universitario de Santiago de Compostela Servicio de Cardiología, Santiago De Compostela, A Coruña, Spain.
Background: The SCN5A gene polymorphism histidine-558-to-arginine (H558R) has been associated with atrial fibrillation (AF) and may affect the therapeutic effects of flecainide. This study aimed to assess the prevalence of the H558R polymorphism in a European cohort of patients with AF and examine its association with flecainide's effects on AF recurrence and toxicity.
Methods: This cohort study included patients diagnosed with AF and prescribed flecainide between 2017 and 2021 in a regional health area.
Flecainide toxicity with pill-in-pocket approach from accidental overdose: a case report.
Eur Heart J Case Rep
October 2024
Division of Electrophysiology, Department of Cardiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467, USA.
Background: The Pill-in-the-Pocket (PiP) approach may be used in highly selected patients to achieve acute pharmacological cardioversion into sinus rhythm. Flecainide toxicity is rarely reported, especially with patients who take flecainide as PiP, and only limited evidence exists in its management. We present a case of accidental flecainide overdose for a patient who is on PiP and the acute management strategy.
View Article and Find Full Text PDFFlecainide Toxicity From Clinical Pharmacology Perspectives.
Cureus
July 2024
Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN.
Article Synopsis
- - The case involves an 84-year-old woman who experienced flecainide toxicity after being treated for paroxysmal atrial fibrillation, indicated by elevated serum concentration levels and a change in heart rhythm upon hospital admission.
- - After discontinuation of flecainide, her dangerous heart rhythm improved, highlighting the drug's excessive effects based on the calculated half-life.
- - The measured half-life of flecainide was 56.8 hours, significantly longer than the advertised 11 hours, emphasizing the need for careful therapeutic drug monitoring in patients using antiarrhythmic medications.
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