Successful use of lidocaine hydrochloride in the management of ventricular arrhythmias in a case of pilsicainide intoxication

Figures

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  Figure 1. Twelve-lead electrocardiogram (ECG) upon admission. A: Upon admission, the ECG revealed sinus rhythm with a wide QRS complex and premature ventricular complexes (arrowheads). The red arrows indicate ST elevation during sinus rhythm. B: Sustained ventricular tachycardia occurred just before the administration of lidocaine.

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  Figure 2. Telemetry strips before and after lidocaine hydrochloride administration. Following the administration of lidocaine hydrochloride (100 mg), ventricular tachycardia immediately ceased (blue arrow).

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  Figure 3. Changes in QRS width over time. As the concentration of pilsicainide decreased, the QRS width decreased. VT = ventricular tachycardia.

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  Supplemental Figure 1. Atrioventricular dissociation during sinus rhythm with frequent premature contractions and ventricular tachycardias Sinus rhythm with frequent PVCs (A). AV dissociation was seen during VT (B). AV: atrioventricular, PVC: premature ventricular contraction, VT: ventricular tachycardia

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  Supplemental Figure 2. Changes in ECG parameters and pilsicainide concentration over time The red arrows represent lidocaine injections, while the blue bar indicates the continuous infusion of lidocaine for the next 12 hours. Cre: creatinine, HR: heart rate, QTc: corrected QT interval

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  Supplemental Figure 3. 12-lead ECG immediately after termination of ventricular tachycardia The last cycle length of VT was slightly longer compared to the previous cycle length. VT: ventricular tachycardia