An irregular, extremely broad QRS complex rhythm

Adriaan Wilgenhof; Vincent Michiels; Bernard Cosyns

doi:10.1016/j.ajem.2019.158356

An irregular, extremely broad QRS complex rhythm

Am J Emerg Med. 2019 Oct;37(10):1989.e1-1989.e3. doi: 10.1016/j.ajem.2019.158356. Epub 2019 Jul 21.

Authors

Adriaan Wilgenhof¹, Vincent Michiels², Bernard Cosyns³

Affiliations

¹ Department of cardiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. Electronic address: [email protected].
² Department of cardiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. Electronic address: [email protected].
³ Department of cardiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. Electronic address: [email protected].

PMID: 31362853
DOI: 10.1016/j.ajem.2019.158356

Abstract

We report a case of a 74-year-old lady admitted to the emergency department with a very broad QRS complex caused by flecainide intoxication due to acute renal failure. Appropriate recognition of the ECG changes and symptoms provoked by flecainide intoxication permitted quick directed treatment with intravenous administration of high dose sodium bicarbonate, which resolved the QRS elongation.

Keywords: Acute renal failure; Broad QRS complex; Drug toxicity; Flecainide.

Publication types

Case Reports

MeSH terms

Accidental Falls
Aged
Anti-Arrhythmia Agents / adverse effects*
Anti-Arrhythmia Agents / therapeutic use
Drug Overdose
Electrocardiography
Fatigue / chemically induced
Female
Flecainide / adverse effects*
Flecainide / therapeutic use
Humans
Sodium Bicarbonate / therapeutic use*
Tachycardia, Ventricular / chemically induced*
Tachycardia, Ventricular / drug therapy
Tachycardia, Ventricular / physiopathology
Treatment Outcome

Substances

Anti-Arrhythmia Agents
Sodium Bicarbonate
Flecainide