contraindications

Last reviewed 01/2018

• should not be used in patients with evidence of previous MI
• relatively contraindicated in patients with heart failure, cardiomyopathy, haemodynamically significant valvular heart disease (1)
• hepatic or renal impairment can lead to a reduction in elimination of flecainide
• flecainide may lead to a depression in myocardial function and may cause heart failure

Notes:

• the BNF states that heart failure and haemodynamically significant valvular heart disease are both contraindications to the use of flecainide
• flecainide has also been associated with proarrhythmia in some children, and there are reports of an increased incidence of sudden death among patients with atrial flutter, structural heart disease and cardiomyopathies (3)

Reference:

1. Prescribers' Journal (1999), 39 (4), 222-26.
2. BNF 2.3.2
3. Kugler JD.Radiofrequency catheter ablation for supraventricular tachycardia: should it be used in infants and small children?. Circulation 1994;90:639–641
4. Fish FA et al. Proarrhythmia, cardiac arrest and death in young patients receiving encainide and flecainide. J Am Coll Cardiol 1991;18:356–365.