Reversal of Brugada electrocardiographic pattern with sodium bicarbonate solution after amitriptyline overdose

Chan, Ho Yin; Chan, Yuk Wah; Lau, FL

doi:10.1080/15563650802293984

Cited by 7 publications

(3 citation statements)

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“…In another report, reversal of Brugada pattern in ECG following TCA intake by sodium bicarbonate infusion was presented. In this case, amitriptyline overdose induced Type 1 Brugada pattern which was reversed by 150 mEq of intravenous sodium bicarbonate was reported [11].…”

Section: Relationship Between Brugada Syndrome and Specific Toxic Agentsmentioning

confidence: 60%

Relationship Between Brugada Syndrome and Poisoning

Erenler¹,

Komut²,

Çapraz³

et al. 2020

Am J Res Med Sci

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Brugada syndrome is an inherited arrhythmogenic disease, characterised by a coved-type ST segment elevation in right precordial leads and an increased risk of sudden cardiac death due to ventricular arrhythmia. Electrocardiographic patterns of the disease is divided into three as: a) type I, characterized by a coved-type ST-segment elevation ≥ 2 mm in more than one right precordial lead (V1-V3), followed by negative T wave; b) type II, characterized by ST-segment elevation ≥ 2 mm in right precordial leads followed by positive or biphasic T waves, resulting in a saddleback configuration; and c) type III, defined as any of the 2 previous types if ST-segment elevation is ≤ 1 mm. Although genetic basis of the disease is described (mutations in SCN5A, a cardiac sodium channel gene, transmitted in an autosomal dominant pattern), there is a lack of information about its relationship with triggering factors, particularly toxins. Even though the literature knowledge mainly depends on case reports, in this review, our aim was to investigate the relationship between BrS and toxins, and create awareness on clinicians about this fatal entity.

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Section: Relationship Between Brugada Syndrome and Specific Toxic Agentsmentioning

confidence: 60%

Relationship Between Brugada Syndrome and Poisoning

Erenler¹,

Komut²,

Çapraz³

et al. 2020

Am J Res Med Sci

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“…Tricyclic antidepressants have been reported to induce the BrS pattern on ECG over a wide range of antidepressant dosages [39]. Amitriptyline, a tricyclic antidepressant, has recently been reported to induce the BrS phenotype in clinics [40–43] as well as in an experimental model [44]. Amitriptyline was shown to cause an outward shift in the balance of current activity during the early phases of the epicardial AP by reducing the peak sodium channel current.…”

Section: Psychotropic Drugsmentioning

confidence: 99%

Drug‐induced Brugada syndrome

Minoura

Kobayashi

Antzelevitch

2013

Journal of Arrhythmia

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a b s t r a c tBrugada syndrome (BrS) is an inherited cardiac disorder that is associated with an electrocardiogram pattern of ST segment elevation on right precordial leads and a high incidence of sudden death. Diagnosis requires documentation of a coved-type ST segment that occurs spontaneously or in the presence of a class IA or IC antiarrhythmic agent. A wide variety of other drugs, including antianginals, antidepressants, antipsychotics, and antihistamines, have been reported to unmask or induce the electrocardiographic and arrhythmic manifestations of BrS. This review focuses on drug-induced BrS phenotypes, prevalence, and underlying mechanisms.

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“…[2] Therefore, sodium bicarbonate is used for treatment of two conditions discussed above. [45–8] Sodium bicarbonate with its effective alkalization effect is the base of treatment in lethal cardiac toxicity in TCA intoxication.…”

Section: Introductionmentioning

confidence: 99%