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Persistent wandering atrial pacemaker after epinephrine overdosing - a case report.

Elhadi H Aburawi¹, Hassib Narchi, Abdul-Kader Souid

¹Department of Pediatrics, College of Medicine and Health Science, United Arab Emirates University, Al-Ain, UAE. e.aburawi@uaeu.ac.ae

|January 4, 2013

Summary

Sympathomimetic drug overdosing in young children can cause serious heart rhythm problems like multifocal atrial tachycardia. Wandering atrial pacemaker may be a persistent complication requiring further investigation.

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Published on: September 24, 2021

Area of Science:

Pediatric Cardiology
Clinical Toxicology
Pharmacovigilance

Background:

Long-term complications of sympathomimetic drug overdose in pediatric populations remain under-investigated.
Despite warnings, sympathomimetic formulations are commonly used for pediatric upper respiratory symptoms.
Arrhythmias, including multifocal atrial tachycardia, are known adverse events.

Observation:

A 3-year-old child experienced multifocal atrial tachycardia after an accidental intravenous overdose of epinephrine.
Electrocardiogram (ECG) revealed a persistent wandering atrial pacemaker for over a year.
This case highlights the heightened sensitivity of young children to sympathomimetic drug toxicity.

Findings:

Multifocal atrial tachycardia occurred following sympathomimetic overdose in a toddler.
Wandering atrial pacemaker was a prolonged ECG finding post-overdose.
Pediatric patients exhibit significant sensitivity to sympathomimetic drug overdoses.

Implications:

Healthcare providers and parents need to be alerted to the toxic risks of sympathomimetic overdosing in children.
Further research is necessary to ascertain if wandering atrial pacemaker is a potential long-term sequela of high-dose sympathomimetic exposure.
This underscores the importance of cautious prescribing and administration of sympathomimetic medications in pediatric care.