{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:51:55Z","timestamp":1790009515236,"version":"4.0.1"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:p>Flecainide acetate is a Vaughan-Williams class IC antiarrhythmic drug prescribed for the treatment of supraventricular arrhythmias. It has a narrow therapeutic index and proarrhythmic effects even at therapeutic doses. Flecainide is metabolized by a CYP2D6 enzyme that exhibits polymorphism. In this case report, we present, to our best knowledge, the first case of toxicity contributed by genetic polymorphism in an infant. Our patient with recurrent supraventricular tachycardia was treated with a therapeutic dose of flecainide but developed heart block requiring extracorporeal membrane oxygenation support and subsequent treatment with lipid emulsion therapy. He was found to have supratherapeutic serum flecainide concentration, and gene testing revealed the patient to be an intermediate metabolizer. With this case report, we reinforce the importance of evaluating the CYP2D6 genotype before drug initiation in the neonatal population and recommend regular monitoring of serum flecainide levels and electrocardiograms in these patients.<\/jats:p>","DOI":"10.1542\/peds.2019-2608","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T12:24:38Z","timestamp":1592569478000},"source":"Crossref","is-referenced-by-count":9,"title":["Complete Heart Block Secondary to Flecainide Toxicity: Is It Time for CYP2D6 Genotype Testing?"],"prefix":"10.1542","volume":"146","author":[{"given":"Bao Hui","family":"Poh","sequence":"first","affiliation":[{"name":"Departments of Pharmacy,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Hau","family":"Lee","sequence":"additional","affiliation":[{"name":"Children\u2019s Intensive Care Unit, KK Women\u2019s and Children\u2019s Hospital, Singapore; and"},{"name":"Medical School, Duke\u2013National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Alim","family":"Abdul Haium","sequence":"additional","affiliation":[{"name":"Neonatology, and"},{"name":"Medical School, Duke\u2013National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Liang Jonathan","family":"Choo","sequence":"additional","affiliation":[{"name":"Paediatric Subspecialties (Cardiology) and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"issue":"3","key":"2021121105054530500_B1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.hrcr.2015.12.013","article-title":"Management of life-threatening flecainide overdose: a case report and review of the literature","volume":"2","author":"Vu","year":"2015","journal-title":"HeartRhythm Case Rep"},{"issue":"6","key":"2021121105054530500_B2","doi-asserted-by":"crossref","first-page":"807","DOI":"10.7326\/0003-4819-106-6-807","article-title":"Life-threatening flecainide toxicity. 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