Clinical presentation

Clinical onset of flecainide poisoning is rapid, within 30 to 60 minutes of ingestion.

Effects of flecainide poisoning include:

• cardiovascular effects
  • QRS widening; a QRS complex wider than 200 milliseconds is associated with severe cardiovascular toxicity, higher rates of mechanical ventilation and death
  • QT-interval prolongation
  • bradycardia with variable atrioventricular (AV) nodal block
  • ventricular tachycardia, ventricular fibrillation, asystole and pulseless electrical activity, death
  • hypotension, pulmonary oedema
• central nervous system effects—sedation and dizziness; coma and seizures in more severe cases
• gastrointestinal effects—nausea, vomiting
• metabolic effects—hypokalaemia, hyperglycaemia, metabolic acidosis.