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Document Details :
Title: Auto-intoxication with flecainide and quinapril
Subtitle: ECG-changes, symptoms and treatment
Author(s): VAN REET, Bert , DENS, Joseph
Journal: Acta Cardiologica
Volume: 61 Issue: 6 Date: December 2006
Flecainide acetate is a sodium channel blocker and a class Ic antiarrhythmic agent with potential life-threatening proarrhythmic and cardioinhibitory properties when taken in overdose. Quinapril is an angiotensin-converting enzyme inhibitor (ACE-inhibitor) and overdose can lead to prolonged hypotension and, less frequently, transient renal impairment.We describe the first published case of intoxication with both drugs.The patient developed a broad-QRS-tachycardia and severe hypotension. Treatment with volume expansion, hypertonic sodium bicarbonate, inotropic support with norepinephrine and insertion of an intra-aortic balloon pump led to complete recovery after 72 hours. We assume that the clinical picture was mainly dictated by flecainide intoxication. Relevant literature data are discussed.