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

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

Anna Correra  1 , Assunta Merola  2 , Michela Palma  2 , Emanuele Romeo  3 , Diego Colonna  2 , Annalisa Passariello  4 , Maria Giovanna Russo  4 , Berardo Sarubbi  3
Affiliations

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

Anna Correra et al. J Electrocardiol. 2021 May-Jun.

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.

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