Summary
A 79-year-old patient, who had received a pacemaker after suffering two posterior myocardial infarctions, was treated with 2 × 100 mg flecainide daily for 9 days for ventricular extrasystoles (Lown IV b). On admission to the hospital the parameters of renal function were within the normal range. Ten days after flecainide treatment was begun a temporary electromechanic decoupling of the pacemaker occurred with reversible asystoly and progressive kidney failure. The flecainide plasma level at that time was 1460 ng/ml. Hemoperfusion for 3 h with activated charcoal removed only 35 mg flecainide in spite of an excellent flecainide clearance (164–180 ml/min). The patient's flecainide plasma level did not decrease sufficiently during the procedure, showing clearly that flecainide levels cannot be lowered fast enough by hemoperfusion to treat a flecainide intoxication.
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Wurzberger, R., Witter, E., Avenhaus, H. et al. Hämoperfusion bei Flecainidintoxikation. Klin Wochenschr 64, 442–444 (1986). https://doi.org/10.1007/BF01727530
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DOI: https://doi.org/10.1007/BF01727530