• J Emerg Med · Mar 1997

    Case Reports

    Sodium bicarbonate to correct widened QRS in a case of flecainide overdose.

    • M J Goldman, J B Mowry, and M A Kirk.
    • Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212-4772, USA.
    • J Emerg Med. 1997 Mar 1;15(2):183-6.

    AbstractA 16-yr-old male attempted suicide by ingesting approximately 4000 mg of flecainide. He developed coma, hypotension, and ventricular tachycardia. In addition to supportive care and antidysrhythmics, he received intravenous sodium bicarbonate for the wide complex dysrhythmia. Animal studies and anecdotal human experience have suggested that increasing the extracellular sodium improves cardiac conduction in flecainide toxicity. The patient's QRS narrowed immediately following sodium bicarbonate infusion. Sodium bicarbonate may be useful in the treatment of widened QRS and ventricular ectopy resulting from flecainide toxicity.

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