Question Title: Ectopic Atrial Tachycardia & Flecinide

My 63 year old Mother has been diagnosed with Ectopic Atrial Tachycardia. After a surgical procedure it was determined that
ablation would cause the need for a pacemaker so the ablation wasn't done. Now it is being suggested that she try Flecinide. We
are concerned about any potential side effects and how drug therapy would compare to a pacemaker. Please help.

Sincerely, Leslie Levy

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Dear Leslie,
Although any drug has potential side effects (especially antiarrhythmics like flecanide which can be proarrhythmic-i.e cause an arrhythmia!)
so do procedures and committing a person so young to life long pacemaker therapy. Another down side to a pacemaker is you are not preserving the hearts' natural rhythm.
So in general we as cardiologists do not put in pacemakers until it is very much indicated and there are really no other options.
And it may eventually come to just this- pacemaker implantation as the only option.
As for Flecanide, it is a good drug and works the large majority of the time to suppress the arrythmia (in your mother's case the arrythmia is a.fib.)
Flecanide should never be used (except as an absolute last resort) in those patients with left ventricular dysfunction and/or coronary artery disease.
So the electrophysiologist-cardiologist who is caring for your mother is really treating her as best s/he can, minimizing the risk as much as possible, and
doing it in a very stepwise, logical fashion. Keep up to date with the doc's thinking however by asking him his plan and what alternatives he has in mind
should the current treatment not work. Good Luck.
Information provided in the heart forum is intended for general medical informational purposes only, actual
diagnosis and treatment can only be made by your physician(s).

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