Department of Emergency Medicine, The Townsville Hospital, Townsville, Queensland, Australia.
Am J Emerg Med. 2012 Nov;30(9):2095.e1-2. doi: 10.1016/j.ajem.2012.01.005. Epub 2012 Mar 3.
A 23-month-old boy was brought to the emergency department of an adult and pediatric tertiary care center 1 hour after an inadvertent “double dose” of 120 mg flecainide (9.2 mg/kg). His electrocardiogram revealed sinus rhythm with a terminal R wave in aVR greater than 7 mm, a bifascicular block, and prolonged QRS and QTc intervals. A dramatic improvement in the bifascicular block and terminal R wave occurred after the administration of sodium bicarbonate. He was discharged after 36 hours with no complications. This case demonstrates that flecainide can cause significant cardiac conduction disturbances in doses much lower than previously described. All supratherapeutic ingestions should be assessed in hospital.
一名 23 个月大的男孩在误服 120mg 氟卡尼（9.2mg/kg）“双倍剂量”后 1 小时被带到成人和儿科三级保健中心的急诊科。他的心电图显示窦性心律，aVR 导联终末 R 波大于 7mm，双束支阻滞，以及 QRS 和 QTc 间期延长。给予碳酸氢钠后，双束支阻滞和终末 R 波明显改善。他在 36 小时后出院，没有出现并发症。该病例表明，氟卡尼在低于先前描述的剂量时也可引起明显的心脏传导障碍。所有超治疗剂量的摄入都应在医院进行评估。
