Why the study?
Does high dose sodium bicarbonate improve widened QRS in patients with flecainide poisoning?
Does high dose sodium bicarbonate improve widened QRS in patients with flecainide poisoning?
High dose sodium bicarbonate may be an effective treatment for reversing widened QRS and stabilizing patients with class Ic anti-arrhythmic drug overdose.
May inform flecainide toxicity management; hypothesis-generating case report requiring prospective validation.
Flecainide is a class Ic anti - arrhythmic drug with sodium channel blocking activities. We report a case of a 57 year - old woman who attempted a suicide by ingesting approximately 1,8 gr of flecainide. On the surface electrocardiogram this results in a large QRS complex and in prolongation of the QTc interval. Overdose with a class Ic drug is very uncommon, its management is difficult and the mortality high.Because of a hemodynamic instability and in addition to supportive care and antidysrhythmics, she was treated with a high dose of sodium bicarbonate in hypertonic solution; after this infusion the patient's QRS progressive narrowed.In conclusion, sodium bicarbonate may be useful in the treatment of widened QRS and to stabilize a overdose of class Ic anti - arrhythmic drugs.
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Rognoni et al. (2009) studied this question.
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