Spontaneous Resolution Of Arrhythmia in Propafenone Intoxication: A Rare Case Report

Abstract

Propafenone toxicity is rare but poses a life-threatening condition due to malignant arrhythmias. However, there is currently no recommended standard specific treatment or antidote. In our case, we presented a young patient with transient cardiac toxicity and spontaneous recovery in her follow up after taking high-dose propafenone for suicide attempt. Electrocardiography showed sinus rhythm with prolongation of PR interval with 240 ms, QRS width 160 ms, and corrected QT interval QTc with 498 ms; Terminal R wave observed in leads V1 and aVR and metabolic acidosis was also observed at the time of admission. In patient's follow up, sodium bicarbonate and lipid emulsion treatment was planned but did not applied due to the resolution of cardiotoxic arrhythmia in 30 minutes after her admission, and metabolic acidemia was observed to regress with supportive treatment. In conclusion, propofenone intoxication, like other class 1C antiarrhythmics, is a life-threatening, rarely reported toxicity that complicates clinical decisions. It is critical to be aware that propofenone overdose can be fatal, and is also essential to remember that, despite the lack of an antidote, total recovery can be accomplished with constant monitoring and supportive treatment.