Life-threatening flecainide overdose treated with intralipid and extracorporeal membrane oxygenation.
Flecainide is a Class Ic antiarrythmic agent associated with adverse events due to its pro-arrythmic effects. We report the case of a 33-year-old female presenting in cardiac arrest after a flecainide overdose treated with intravenous fat emulsion (IFE), sodium bicarbonate (NaHCO₃), and extracorporeal membrane oxygenation (ECMO). This case reviews the pathophysiology and management of flecainide toxicity including novel strategies of IFE and ECMO.
Harvard Affiliated Emergency Medicine Residency, Brigham and Women's Hospital/Massachusetts General Hospital, Boston, MA, USA. Electronic address: ebrumfield@partners.org.
Emily
E
Brumfield
Harvard Affiliated Emergency Medicine Residency, Brigham and Women's Hospital/Massachusetts General Hospital, Boston, MA, USA. Electronic address: kbernard@partners.org.
Kenneth R L
KR
Bernard
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: ckabrhel@partners.org.
Christopher
C
Kabrhel
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000506:poisoning*; D062787:Drug Overdose / Q000628:therapy*; D004562:Electrocardiography; D015199:Extracorporeal Membrane Oxygenation; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use; D005260:Female; D005424:Flecainide / Q000506:poisoning*; D006323:Heart Arrest / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D017693:Sodium Bicarbonate / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D005217:Fat Emulsions, Intravenous; D017693:Sodium Bicarbonate; D005424:Flecainide