Electrocardiographic changes in a rare case of flecainide poisoning: a case report
Andrea Rognoni1, Marzia Bertolazzi, Marzia Peron
1Department of Cardiology, Sant'Andrea Hospital, Corso Mario Abbiate 21, 13100, Vercelli, Italy.
Abstract:
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.
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