A frightening giant QRS complex in a 3-months-old infant

J Electrocardiol. 2021 May-Jun:66:16-17. doi: 10.1016/j.jelectrocard.2020.07.012. Epub 2020 Jul 30.

Abstract

A 3-months-old infant was urgently admitted for drowsiness and lack of appetite started 24 h before. The ECG showed sinus rhythm with a prolonged AV interval (200 ms) and very large QRS complexes (280 ms) due to Flecainide overdosing following incorrectly administration for poor communication between parents resulted in both giving a dose to the infant. Flecainide serum level was 1.2μg/ml, confirming the diagnosis of an accidental drug intoxication. The patient started continue hydration with a close monitoring. Three hours later a significant narrowing of the QRS complex (150 ms) was observed, then over the following 24 h, the QRS almost completely normalized.

Keywords: Flecainide overdosing; QRS; Therapeutic error; Toxicity.

MeSH terms

  • Anti-Arrhythmia Agents* / therapeutic use
  • Drug Overdose*
  • Electrocardiography
  • Flecainide
  • Humans
  • Infant

Substances

  • Anti-Arrhythmia Agents
  • Flecainide