Case Report
Electrocardiographic changes in a rare case of flecainide poisoning: a case report
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* Corresponding author: Andrea Rognoni arognoni@hotmail.com
1 Department of Cardiology, Sant'Andrea Hospital, Corso Mario Abbiate 21, 13100, Vercelli, Italy
2 Emergency Department and Intensive Care Unit, Sant'Andrea Hospital, Corso Mario Abbiatr 21, 13100 Vercelli, Italy
Cases Journal 2009, 2:9137 doi:10.1186/1757-1626-2-9137
Published: 3 December 2009Abstract
Flecainide is a class Ic anti - arrhythmic drug with sodium channel blocking activities. We report a case of a 57 year - old woman who attempted a suicide by ingesting approximately 1,8 gr of flecainide. On the surface electrocardiogram this results in a large QRS complex and in prolongation of the QTc interval. Overdose with a class Ic drug is very uncommon, its management is difficult and the mortality high.
Because of a hemodynamic instability and in addition to supportive care and antidysrhythmics, she was treated with a high dose of sodium bicarbonate in hypertonic solution; after this infusion the patient's QRS progressive narrowed.
In conclusion, sodium bicarbonate may be useful in the treatment of widened QRS and to stabilize a overdose of class Ic anti - arrhythmic drugs.