title: [Successful multiple resuscitation in flecainide poisoning].
abstract: After a family quarrel a 37-year-old woman swallowed, with suicidal intent, a large number of flecainide tablets (exact amount unknown) together with alcohol. On admission to hospital some hours later her pupils were fully dilated, fixed and of irregular outline; she was unconscious and in cardiorespiratory failure. Nine hours after admission several episodes of ventricular fibrillation and asystole occurred, two of them lasting for 2 and 3 hours, respectively, before successful resuscitation (after defibrillation). The highest plasma flecainide level, between 3 and 10 hours after swallowing the drug, was 6160 ng/ml, i.e. six times the maximal therapeutic level. Under the influence of flecainide the ECG of the previously healthy woman had shown idioventricular rhythm with marked QRS widening and Q-T prolongation. The tachyarrhythmias, at times torsades de pointes, were successfully treated with high doses of lidocaine (4 g daily) after repeated defibrillations. As a late complication the patient went into acute left ventricular failure with pulmonary edema and pneumonia. There were no recognizable permanent sequelae on discharge 37 days after admission.
authors.affiliation: II. Medizinische Klinik, Universität Heidelberg.
authors.forename: K D
authors.initials: KD
authors.lastname: Palitzsch
authors.forename: H
authors.initials: H
authors.lastname: Bode
authors.forename: K
authors.initials: K
authors.lastname: Huck
authors.forename: K H
authors.initials: KH
authors.lastname: Usadel
mesh_terms: D000328:Adult; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D005424:Flecainide / Q000506:poisoning*; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D012151:Resuscitation; D013610:Tachycardia / Q000139:chemically induced / Q000628:therapy; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000139:chemically induced / Q000628:therapy
chemical_list: D005424:Flecainide
vernacular_title: Erfolgreiche Mehrfachreanimation bei Flecainid-Intoxikation.