Introduction: Propafenone is a class I C Vaughan Williams anti-arrhythmic and it is used to treat ar-rhythmias in patients without structural conditions of the heart. Although it is well tolerated in most patients, cardiovascular and noncardiovascular side effect may occur. Cholestasis syndrome is one of the rarest.

Methods: We present the case of a 64-year-old pati-ent, without hepatobiliary conditions known, who had been treated with propafenone for paroxysmal atrial fibrillation with multiple recurrences, who manifested at the last evaluation intermittent sensation of emesis accompanied by cytolysis and cholestasis syndrome.

Results: The discontinuance of propafenone was enou-gh for the disappearance of clinical accuses and the re-gression of biological parameters.

Conclusions: T he initial exclusion of infectious and structural etiologies demands a careful re-evaluation of the history for the fast identification of drug hepatoto-xicity.