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Related Experiment Videos

Flecainide overdose--support using an intra-aortic balloon pump.

Jonathan Timperley1, Andrew R J Mitchell, Peter D Brown

  • 1Department of Cardiac Rhythm Management, John Radcliffe Hospital, Oxford, OX3 9DU, UK. jon.timperley@orh.nhs.uk

BMC Emergency Medicine
|December 14, 2005
PubMed
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Flecainide overdose can be fatal, causing severe heart problems. An intra-aortic balloon pump helped a patient with flecainide-induced cardiogenic shock recover, highlighting its supportive role in managing toxicity.

Area of Science:

  • Cardiology
  • Clinical Toxicology

Background:

  • Flecainide is an antiarrhythmic drug increasingly used for supraventricular arrhythmias.
  • Flecainide overdose carries a high mortality rate (up to 22%) due to cardiac complications.
  • Supportive therapies like inotropes and mechanical support are crucial in managing flecainide toxicity.

Purpose of the Study:

  • To report a case of severe flecainide overdose.
  • To highlight the utility of intra-aortic balloon pump as a supportive measure in flecainide-induced cardiogenic shock.

Main Methods:

  • A 47-year-old female presented with chest pain and ECG abnormalities consistent with atrial fibrillation and broad QRS complexes.
  • She developed cardiogenic shock and impaired left ventricular function after thrombolysis for presumed myocardial infarction.

Related Experiment Videos

  • An intra-aortic balloon pump was inserted, followed by inotropic support, leading to recovery.

    • Main Results:

    • Coronary angiography revealed normal coronary arteries, ruling out acute myocardial infarction.
    • The patient's QRS duration and left ventricular function normalized over 48 hours with supportive care.
    • Elevated flecainide levels were confirmed biochemically post-discharge.

    Conclusions:

    • Intra-aortic balloon pump insertion is a valuable supportive intervention in acute flecainide overdose.
    • Prompt management with mechanical circulatory support can improve outcomes in severe flecainide-induced myocardial depression.