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European Heart Journal 1992 13(1):137-139;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Pseudo infarction ECG pattern occurring during intravenous treatment with flecainide acetate

K. J. J. C. M. VAN AUBEL, J. H. RUITER, A. E. R. ARNOLD and C. BURGERSDIJK

Department of Cardiology, Medical Centre Alkmaar Wilhelminalaan 12, 1815 JD Alkmaar, the Netherlands

Received 24 October 1990; revised 7 December 1990; .

Correspondence: J. H. Ruiter, Department of Cardiology, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, the Netherlands

Abstract

A 79-year-old woman presented with atrial flutter and anginal complaints, which remitted on nitroglycerin but the flutter did not respond to digoxin and verapamil. Flecamide acetate was given intravenously; administration was stopped because of development of a significant increase in the QRS duration, existence of prominent deep Q waves and marked ST elevation in leads V1 to V4. These abnormalities mimicked the ECG changes seen in myocardial infarction. However, the presence of an acute myocardial infarction could be ruled out. On a second admission intravenous flecainide acetate resulted in comparable marked ECG changes.

Key Words: Flecainide acetate • pseudo infarction • conduction block


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