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Bicarbonate refractory QRS prolongation and left bundle-branch block following escitalopram and lamotrigine overdose: A case report and literature review of toxic left bundle-branch block. J Clin Pharm Ther 2018 Oct;43(5):717-722

Date

05/04/2018

Pubmed ID

29722042

DOI

10.1111/jcpt.12698

Scopus ID

2-s2.0-85046267209 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

WHAT IS KNOWN AND OBJECTIVE: Toxic prolongation of the QRS interval most often results from blockade of cardiac voltage-gated sodium channels and manifests on electrocardiogram with a right bundle-branch block-like morphology. Rarely, a left bundle-branch block (LBBB) morphology has been reported.

CASE REPORT: We report a case of transient LBBB resultant from ingestion of lamotrigine and citalopram which was refractory to sodium bicarbonate therapy and eventually resolved spontaneously.

WHAT IS NEW AND CONCLUSION: Cases of toxic LBBB are less likely to respond to bicarbonate therapy, suggesting that this finding is due to a mechanism other than sodium channel blockade.

Author List

Farkas AN, Marcott M, Yanta JH, Pizon AF

Author

Andrew N. Farkas MD Associate Professor in the Emergency Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Arrhythmias, Cardiac
Bicarbonates
Bundle-Branch Block
Citalopram
Electrocardiography
Female
Humans