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February 1990

Placental Transfer of Flecainide

Am J Dis Child. 1990;144(2):144. doi:10.1001/archpedi.1990.02150260022014

Sir.—Flecainide, a local anesthetic–type antiarrhythmic agent, has recently been approved for use in the United States. To augment the little available information regarding its use during pregnancy and effects on the neonate, we present the following patient report.

Patient Report.—A 24-year-old woman, gravida 5, para 1-0-3-1, presented at 37 weeks' gestation with spontaneous rupture of membranes. Review of her medical history revealed mitral valve prolapse with moderate to severe mitral regurgitation. In the fifth month of her pregnancy she began taking metoprolol for increasingly symptomatic supraventricular tachycardia, with an initial good response. By 35 weeks' gestation, however, the patient's symptoms had worsened; a repeated electrocardiogram at that time disclosed Wolf-Parkinson-White syndrome, type A. Administration of metoprolol was discontinued, and she began taking flecainide, 100 mg by mouth two times per day; the dosage was subsequently increased to 150 mg two times per day, with symptomatic improvement.