Acute Propafenone Toxicity Discovered after Unknown Onset of Symptoms

Propafenone is a class 1C antiarrhythmic with sodium channel and beta blocking properties. At toxic doses it causes wide range of arrhythmias including cardiac conduction abnormalities, AV block and prolongation of QRS complexes that may be fatal. In this paper we report a young female patient who had unstable hemodynamic condition due to propafenone ingestion estimated to be 6000 mgr and successfully treated with bicarbonate therapy. Bicarbonate therapy seems to be effective in propafenone intoxication and emergency physicians might be familiar to sodium channel blocking agent toxidromes and potential benefits of bicarbonate administration