Which medications in the drug class Antidysrhythmics, Class IC are used in the treatment of Atrial Flutter?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Antidysrhythmics, Class IC

Class IC antidysrhythmics are indicated for use in patients with atrial flutter and supraventricular tachycardia (SVT) without structural heart disease. Because conversion to atrial flutter with 1:1 conduction (producing fast ventricular rates) may occur with these agents, they are used in conjunction with atrioventricular (AV) nodal blocking agents in these cases.

Propafenone (Rythmol)

Propafenone treats life-threatening arrhythmias. It possibly works by reducing spontaneous automaticity and prolonging the effective refractory period. It is indicated for patients with atrial flutter and SVT without structural heart disease. Propafenone is used in conjunction with AV nodal blocking agents when administered to patients in atrial fibrillation because conversion to atrial flutter with 1:1 conduction (producing fast ventricular rates) is noted.

Flecainide (Tambocor)

Flecainide treats life-threatening ventricular arrhythmias. It causes prolongation of refractory periods and decreases action potential without affecting duration. This agent blocks sodium channels, producing a dose-related decrease in intracardiac conduction in all parts of the heart, with greatest effect on the His-Purkinje system.

Effects on AV nodal conduction time and intra-atrial conduction times, though present, are less pronounced than those on ventricular conduction velocity. Flecainide is used in conjunction with AV nodal blocking agents when administered to patients in atrial fibrillation because conversion to atrial flutter with 1:1 conduction (producing fast ventricular rates) is noted.


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