Flecainide in Pediatrics

Arrhythmia--irregular heart rate--in children can cause fatigue, dizziness, fainting and palpitations. These symptoms can be debilitating. There are things doctors can do to control a child's arrhythmia. These measures may include medications such as Tambocor (flecainide acetate).

Arrhythmia

• There are many types of arrhythmia, and your child's doctor will be able to tell you exactly which type your child has. Arrhythmia involves irregularities in the electrical signals in your child's heart, which can cause the chambers of the heart not to fill with enough blood if the heart is pumping too fast, or can prevent enough blood from being pumped back out to the body if the heart is beating too slowly. Your child's heartbeat may slow down and speed up unpredictably. These conditions can cause debilitating dizziness, fatigue, fainting and palpitations.

Flecainide

• Flecainide is usually an oral tablet that comes in strengths of of 50, 100 or 150 mg. Your pharmacist may be able to make it in liquid form. It is specifically designed as an antiarrhythmic--a drug that works to even out the rhythm of the heart. It is safe to use in children as long as doctors monitor the levels of it in the bloodstream.

Children's Dosage

• Flecainide is typically give in two or three evenly spaced doses. The initial dose is typically 50 mg per square meter of body surface area (your child's doctor has a formula to calculate this number). The maximum recommended dose, not to be exceeded, is 200 mg per square meter of body surface area. Your doctor will adjust this dosage based on the medicine's effectiveness in treating your child's symptoms, and the way your child's body maintains levels of the medication in the blood. Talk to your doctor about what to do if you miss a dose.

Side Effects and Concerns

• Side effects may include headache, dizziness or light-headedness; nervousness or drowsiness; nausea, vomiting or diarrhea, or pale stools. Call your child's doctor immediately if the following symptoms develop: signs of an allergic reaction, including facial swelling, hives and difficulty breathing; chest pain or palpitations; jaundice (yellowing of eyes or skin) or rash; swelling of hands or feet.

Alternatives

• If your child continues to experience symptoms, your doctor may try cardioversion, in which a small electrical shock is administered to the heart during an electrocardiogram (EKG) if it beats too fast; ablation, which involves treating a localized site of arrhythmia using extreme heat or extreme cold applied through a catheter in the arm or groin; a surgically implanted pacemaker to maintain the rhythm of the heart by regulating the electrical signals; a surgically implanted cardioverter defibrillator, which automatically delivers the necessary electrical shock to the heart to maintain correct rhythm; or, as a last resort, surgical destruction or removal of the site of the arrhythmia.