Suicidal ingestion of flecainide can lead to fatal intoxication with extremely high blood concentrations and severe conduction abnormalities.
Raises awareness of lethal flecainide overdose with conduction block; leaves open refined toxicity thresholds for clinical use.
Two fatalities resulting from suicidal ingestion of flecainide are described. The decedents, ages 33 and 15, were otherwise healthy; both took their mothers' medications. In one case, from electrocardiographic data, there was found a high-grade conduction block with idioventricular rhythm. Blood and tissue samples from autopsy were analyzed for flecainide by gas chromatography/nitrogen-phosphorous detection and gas chromatography/mass spectrometry. Blood concentrations of 93.7 and 100 mg/L flecainide were found.
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Rogers et al. (1993) studied this question.
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