Pacing and Clinical Electrophysiology 2013-03-01

A life-threatening flecainide overdose treated with intravenous fat emulsion.

Heather Ellsworth, Samuel J Stellpflug, Jon B Cole, Joseph A Dolan, Carson R Harris

Index: Pacing Clin. Electrophysiol. 36(3) , e87-9, (2013)

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Abstract

Flecainide is a Vaughan Williams Class Ic antidysrhythmic associated with PR, QRS, and QTc prolongation on the electrocardiogram and development of life-threatening cardiac toxicity in overdose. The cornerstone of treatment is fluid resuscitation and the administration of magnesium and sodium bicarbonate. We report a case of flecainide overdose associated with life-threatening hemodynamic compromise successfully treated with intravenous fat emulsion (IFE) therapy. IFE should be considered as a novel adjunctive therapy in patients with life-threatening toxicity following flecainide overdose.©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.