May consider monitoring flecainide plasma levels, keeping trough plasma levels below 0.7 1.0 mcg/mL) Atrial flutter with 1:1 AV conduction , QT prolongation, torsades de pointes, worsening HF, bradycardia Sinus or AV conduction disease (in absence of pacemaker) Cardiogenic shock Avoid in structural heart disease (including ischemic heart disease) Atrial flutter (unless concomitant AV nodal therapy to avoid 1:1 conduction) Brugada syndrome Renal dysfunction Hepatic dysfunction QT-prolonging drugs Amiodarone, digoxin, ritonavir, saquinavir, tipranavir Propafenone 150 mg every 8 h (immediate release); 225 mg every 12 h (extended release) 300 mg every 8 h (immediate release); 425 mg every 12 h (extended release) (PR and QRS interval should be monitored. Consider dosage reduction with hepatic impairment) Atrial flutter with 1:1 AV conduction , QT prolongation, torsades de pointes, bradycardia, bronchospasm Sinus or AV conduction disease (in absence of pacemaker) Cardiogenic shock Hypotension Reactive airway disease Avoid in structural heart disease (including ischemic heart disease) Atrial flutter (unless concomitant AV nodal therapy to avoid 1:1 conduction) Brugada syndrome Hepatic dysfunction QT-prolonging drugs Drugs with SA and/or AV nodal blocking properties Amiodarone, ritonavir, saquinavir, tipranavir (Continued) Table 7. 