Management of persistent wide QRS in flecainide overdose with magnesium sulphate

Williamson, D; Sinha, Ayush; Frost, Ian; Singh, Vinod

doi:10.1136/emj.2009.081075

Cited by 9 publications

(2 citation statements)

References 11 publications

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“…Few case reports showed success with extracorporeal membrane oxygenation (ECMO), IV magnesium sulfate, and lipid emulsion therapy (LET). [ 8 9 ] LET removes the lipid soluble drugs (lipid sink) from serum and is lifesaving in the context of flecainide toxicity. It may also open voltage-gated sodium channels and thus improve myocardial contractility.…”

Section: Discussionmentioning

confidence: 99%

Flecainide toxicity in a preterm neonate with permanent junctional reciprocating tachycardia

et al. 2017

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We report a case of flecainide toxicity in a premature neonate with permanent junctional reciprocating tachycardia which was managed successfully by reversal of the sodium blockade with intravenous sodium bicarbonate and supportive care. This report highlights the importance of strict supervision and monitoring while administering antiarrhythmic drugs in neonates and prompt institution of appropriate remedial action for treatment when toxicity is suspected.

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Section: Discussionmentioning

confidence: 99%

Flecainide toxicity in a preterm neonate with permanent junctional reciprocating tachycardia

et al. 2017

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“…10 Other case reports have identified IV amiodarone or MgSO4 as the principle agent responsible for terminating flecainide-induced ventricular arrhythmias. 11,12 Because hypotension can develop rapidly after a flecainide overdose, hepatic and renal blood flow is reduced. Measures to maintain vital organ perfusion will enhance flecainide clearance and its redistribution to other body tissues.…”

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confidence: 99%

Flecainide-Induced Torsade de Pointes Successfully Treated with Intensive Pharmacological Therapy

2016

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Flecainide is a class IC anti-arrhythmic drug that acts by blocking the fast inward sodium channels during phase 0 of action potential. It is used to treat both supraventricular and ventricular arrhythmias. However, flecainide is also a pro-arrhythmic agent, and overdose may cause nausea, vomiting, hypotension, bradycardia, varying degrees of atrioventricular block, tachyarrhythmias (such as torsades de pointes [TdP]), and sustained ventricular tachycardia. These symptoms may result in rapid-onset hypotension, with an associated mortality rate as high as 10%. The management of flecainide overdose includes supportive and pharmacological measures; however, difficult cases have been successfully treated with extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pumps. The authors present a case of a patient who visited their hospital with flecainide intoxication and life-threatening arrhythmias, including TdP, ventricular tachycardia, and ventricular fibrillation. The patient was successfully treated with intensive pharmacological therapy.

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Case Files from the University of California San Diego Medical Toxicology Fellowship: Neonatal Flecainide Toxicity from an Accidental Dosing Error

Seltzer,

Schneir

2024

J. Med. Toxicol.

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Management of persistent wide QRS in flecainide overdose with magnesium sulphate

Cited by 9 publications

References 11 publications

Flecainide toxicity in a preterm neonate with permanent junctional reciprocating tachycardia

Flecainide toxicity in a preterm neonate with permanent junctional reciprocating tachycardia

Flecainide-Induced Torsade de Pointes Successfully Treated with Intensive Pharmacological Therapy

Case Files from the University of California San Diego Medical Toxicology Fellowship: Neonatal Flecainide Toxicity from an Accidental Dosing Error

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