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Patient handout

Cocaine-induced atrial flutter (sympathetic + α-adrenergic + Na-channel substrate)

PRODUCTION

1. Your condition

This handout is for cocaine-induced atrial flutter (sympathetic + α-adrenergic + na-channel substrate). Your care team identified this based on: recent cocaine / sympathomimetic use (within 1–24 h) presenting with new atrial flutter on 12-lead ecg (aha 2008 pmid 18391116).

Other reasons your team may use this plan: atrial flutter on ecg + positive urine drug screen for cocaine / amphetamine metabolites (benzoylecgonine detectable 2–4 d post-use); hypertension + tachycardia + agitation + diaphoresis + palpitations after cocaine use with afl pattern — sympathomimetic α-adrenergic crisis with atrial arrhythmia; chronic cocaine user (>1 yr) with recurrent afl — accelerated atrial substrate from repeated arrhythmogenic stimulation (hsue circulation 2002 pmid 12473532).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
lorazepam1–2 mg IVIVq5–15 min PRN sympathetic crisisAHA 2008 Class I (PMID 18391116) — benzo breaks sympathetic crisis, reduces myocardial oxygen demand and BP, often reduces RVR through sympatholytic effect; first-line in cocaine arrhythmia
nitroglycerin0.4 mg SL q5 min × 3 → IV 5–200 mcg/min if persistent HTN or chest painSL/IVcontinuous IV titrate to BP and painAHA 2008 Class I — reverses cocaine-induced coronary vasoconstriction + reduces afterload; preferred over BB acutely
phentolamine1–5 mg IV q5–15 minIVPRN refractory HTNAHA 2008 Class IIa — selective α-block reverses cocaine-induced vasoconstriction without unopposed-α paradox; reverses inadvertent BB-cocaine interaction (Lange NEJM 1989 PMID 2522592)
diltiazem0.25 mg/kg IV bolus → 5–15 mg/h infusion; 120–360 mg/day POIV/POIV bolus + infusion → PO dailyAHA 2008 + ACC/AHA 2025 — non-DHP CCB PREFERRED over β-blocker in cocaine context (no unopposed-α paradox); AVN slowing for AFL rate control; AVOID in HFrEF or hypotension
verapamil5–10 mg IV slowly OR 80–120 mg PO TIDIV/POIV / POAlternative non-DHP CCB; AVOID in HFrEF — AHA 2008 + ACC/AHA 2024 (PMID 38753446)
synchronized_DCCV_100J_biphasic100 J synchronized biphasic; escalate to 200 J if unsuccessfulelectricalsingle shock; may repeat at higher energyACC/AHA 2024 Class I (PMID 38753446); flutter cardioverts at low energies; first ensure cocaine-related hyperadrenergic state is treated to reduce post-CV recurrence + replete K + Mg
amiodarone150 mg IV over 10 min then 1 mg/min × 6 h then 0.5 mg/min × 18 h; 200 mg PO daily maintenanceIV/POload + dailyAcceptable in cocaine context (no β-blocker paradox); minimal pure β-blockade effect; pulm/thyroid/hepatic toxicity with chronic use — ACC/AHA 2024 (PMID 38753446)
apixaban5 mg BID (2.5 mg if 2 of: ≥80 yr, ≤60 kg, Cr ≥1.5)POBIDARISTOTLE (Granger NEJM 2011 PMID 21870978) — preferred DOAC; ACC/AHA 2024 Class I; counseling on adherence critical in cocaine substrate
rivaroxaban20 mg with food (15 mg if CrCl 15–50)POonce dailyROCKET-AF (PMID 21830957); X-VeRT data extends to flutter — ACC/AHA 2024
warfarinINR target 2–3POdailyMechanical valve / severe MS only; INR monitoring may be unreliable in non-adherent cocaine users — ACC/AHA 2024 (PMID 38753446)

Plan: Cocaine-induced atrial flutter — benzo first + diltiazem-preferred rate control + DCCV if unstable + standard AC + AVOID β-blocker monotherapy + cessation mandatory — AHA 2008 (PMID 18391116) + ACC/AHA 2024 (PMID 38753446) + ACC/AHA 2025 ACS

3. When to call your provider

Contact your care team if any of the following happen:

  • Cocaine relapse with arrhythmia → ED + addiction medicine urgent
  • AC bleed → reverse + LAA occlusion candidacy reassessment
  • Worsening cocaine cardiomyopathy → advanced HF / transplant evaluation (with strict cocaine-free requirement)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • Inadvertent β-blocker (metoprolol, propranolol, atenolol, esmolol) administration to active cocaine user → unopposed-α paradox with worsening HTN, coronary vasospasm, potential ischemic event — Lange NEJM 1989 (PMID 2522592)(life-threatening)
  • Documented recurrent cocaine use (positive UDS or self-report) within 30 days of discharge + AFL recurrence requiring ED/hospital readmission
  • Cocaine-related AFL with concurrent troponin rise + ECG ischemic changes (MI suspected) OR severe chest/back pain + discordant arm BPs (aortic dissection suspected) — AHA 2008 mandatory rule-out before AC(life-threatening)
  • Cocaine-related AFL in setting of intentional overdose with co-ingestion of TCA, opioid, alcohol, or other drugs — multi-drug toxidrome with high mortality(life-threatening)

5. Follow-up

COCAINE CESSATION counseling MANDATORY + warm handoff to substance use disorder treatment (mortality lever per Hollander NEJM 2008); cardiology follow-up week 1 + month 1; EP for CTI ablation if recurrent typical AFL; cardiac rehab; AC adherence review + LAA occlusion candidacy if persistent active use; AVOID β-blocker initiation if continued cocaine use — use diltiazem or non-pharmacologic rate control instead

6. Sources

Guideline: 2024 ACC/AHA/ACCP/HRS AF + AFL Joint Guideline (Joglar PMID 38753446) + AHA 2008 Cocaine cardiovascular complications (McCord PMID 18391116) + 2025 ACC/AHA ACS Guideline

  1. pubmed.ncbi.nlm.nih.gov/38753446
  2. pubmed.ncbi.nlm.nih.gov/39050851
  3. pubmed.ncbi.nlm.nih.gov/18391116