Propafenone overdose: Cardiac arrest and full recovery

Intoxication caused by propafenone is very rare, and there are no known detailed epidemiological studies. We present the clinical manifestation of severe propafenone intoxication, successfully treated in a 17 year-old male. He was brought to the Intensive Care Unit after he had taken 3.0g propafenone. The main clinical findings included: sudden cardiac arrest, coma, hypotension, left ventricular failure, bradycardia, sinoatrial block, atrioventricular junctional or/and ventricular tachycardia. During the treatment, transient heart pacing was performed and catecholamines were administered by means of continuous intravenous infusion of pressure doses as well as of infusion liquids. Cessation of toxic signs four hours after admission to hospital was observed. This relatively rare, fully symptomatic intoxication with propafenone deserved to be presented due to the drug's common usage in the treatment of dysrhythmia and life-threatening symptoms of overdosing. The course of the disease was dramatic and the patient survived only thanks to quick resuscitation, artificial ventilation, transient heart pacing, acidosis treatment and administration of pressure doses of catecholamines. (Cardiol J 2010; 17, 6: 619-622)