Flecainide overdose-induced wide-complex tachyarrhythmia treated with sodium bicarbonate infusion

BMJ Case Rep. 2024 Jun 26;17(6):e256391. doi: 10.1136/bcr-2023-256391.

Abstract

Flecainide is a medication used to treat supraventricular and ventricular tachyarrhythmias. Cases of overdoses are rare, however, can lead to significant cardiac effects. In previous cases of flecainide toxicity, treatment with sodium bicarbonate, intravenous lipid emulsion and amiodarone have been reported to be effective in preventing cardiovascular collapse and reestablishing baseline rhythm. Here, we present a case of a man in his 40s presented with flecainide overdose with wide-complex tachycardia that was treated with intravenous sodium bicarbonate following failure of amiodarone to normalise QRS interval.

Keywords: arrhythmias; cardiovascular medicine; pacing and electrophysiology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amiodarone / administration & dosage
  • Amiodarone / adverse effects
  • Anti-Arrhythmia Agents* / administration & dosage
  • Anti-Arrhythmia Agents* / poisoning
  • Drug Overdose* / drug therapy
  • Electrocardiography*
  • Flecainide* / poisoning
  • Humans
  • Infusions, Intravenous
  • Male
  • Sodium Bicarbonate* / administration & dosage
  • Sodium Bicarbonate* / therapeutic use
  • Tachycardia / chemically induced
  • Tachycardia / drug therapy

Substances

  • Flecainide
  • Sodium Bicarbonate
  • Anti-Arrhythmia Agents
  • Amiodarone