A case of flecainide intoxication followed by motorcycle accident

DOI 11 References
  • Tahara Shintaro
    Emergency Department, Hyogo Prefectural Kakogawa Medical Center
  • Ono Yuichiro
    Emergency Department, Hyogo Prefectural Kakogawa Medical Center
  • Tohma Yoshiki
    Emergency Department, Hyogo Prefectural Kakogawa Medical Center

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  • 外傷性ショックが疑われたフレカイニド中毒の1例

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We treated a patient with flecainide intoxication who presented with traumatic shock and ventricular rhythm on initial examination. The patient was an 89-year-old man who had fallen over while riding his motorized bicycle. He was lucid on arrival at the hospital; however, he exhibited ventricular rhythm with a systolic blood pressure of 60-70 mmHg and a heart rate of 75 /min. Ventricular rhythm was considered the cause of low blood pressure, electrical defibrillation was attempted but was failed. Sinus rhythm was restored by the administration of intravenous amiodarone. Coronary angiography was performed to ascertain the cause of the ventricular rhythm, but no evidence of acute coronary syndrome was found. Ventricular rhythm recurred at the end of this study; however, continuous intravenous amiodarone was initiated and sinus rhythm was again restored. The patient had a history of myocardial infarction and atrial fibrillation and had been taking oral flecainide, which resulted in a high concentration of flecainide in the blood and he was diagnosed with flecainide intoxication. Elevated blood concentrations of antiarrhythmics may induce the development of fatal arrhythmias. Detailed confirmation of patients' medical history, evaluation of blood concentrations of drugs, and familiarity with treatment methods are essential.

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