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Arrhythmogenic effect of flecainide toxicity.
Pierre-Yves Nd Courand1, Franck Sibellas, Sylvain Ranc
1pycourand@hotmail.com.
Cardiology Journal
|April 6, 2013
Summary
Flecainide overdose can cause dangerous ventricular tachycardia. Prompt administration of sodium bicarbonate effectively treated the arrhythmia and improved the patient's condition.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Flecainide, a Class 1C antiarrhythmic, is vital for supraventricular arrhythmias.
- Overdoses can precipitate life-threatening ventricular arrhythmias and cardiogenic shock.
Observation:
- A 72-year-old woman presented with wide complex tachycardia (QRS 240 ms) post-flecainide exposure.
- Adenosine 5'-triphosphate (ATP) failed to resolve the tachycardia.
- Initial presentation included mild left congestive heart failure signs, without shock.
Findings:
- Intravenous sodium bicarbonate administration rapidly narrowed the QRS duration and restored sinus rhythm.
- Confirmation of flecainide overdose was established via blood samples.
- The patient experienced progressive clinical improvement following treatment.
Implications:
- Sodium bicarbonate is a crucial intervention for managing flecainide-induced ventricular arrhythmias.
- This case highlights the importance of recognizing and rapidly treating flecainide toxicity.
- Effective management can prevent severe cardiovascular compromise and improve patient outcomes.
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