Cardiology Letters 2026, 35(3):164-168
Acute propafenone toxicity
- 1 I. kardiologická klinika, Arytmologické oddelenie, VÚSCH, a. s.,
- 2 I. kardiologická klinika, Kardiologické oddelenie, VÚSCH, a. s., Košice, Slovenská republika
Propafenone is an antiarrhythmic drug commonly used in the treatment of cardiac rhythm disorders. Although it is considered a relatively safe medication, certain circumstances may lead to its toxicity, resulting in various serious cardiac and extracardiac symptoms. In the presented case report, we describe a patient long-term treated with propafenone for atrial fibrillation who was admitted to the arrhythmology department acutely with severe bradycardia, cardiogenic shock, and ECG changes suggestive of propafenone toxicity. Early management, including vasopressor therapy, temporary cardiac pacing, and administration of sodium bicarbonate, prevented fatal complications and led to complete recovery of the patient's clinical condition.
Keywords: propafenone; toxicity; treatment
Published: August 1, 2026 Show citation
References
- Siddoway LA, Roden DM, Woosley RL. Clinical pharmacology of propafenone: pharmacokinetics, metabolism and concetration-response relations. Am J Cardiol. 1984;54:9-12.
- Haddad E, Collins M. A case of propafenone toxicity in the setting of dehydratation and acute kidney injury. Glob. Cardiol. Sci. Pract. 2024;38:e202438.
- De Lucena LA, Da Costa Fernandes Mesquita F, Madeira MR, Da Silva Maia FGS. Propafenone Toxicity Presenting With Wide QRS and Transient Ventricular Dyskinesia. JACC Case Rep. 2026;31:107523.
- Yeung A, Shanks D, Parwana H, Gin K. Acute propafenone toxicity after two exposures at standard dosing. Can J Cardiol 2010;26:209-210.
- Ovaska H, Ludman A, Spencer EP, Wood DM, Jones AL, Dargan PI. Propafenone Poisoning-A Case Report with Plasma Propafenone Concentrations. J. Med. Toxicol. 2010;6:37-40.
- Kara I, Bengi Celik J, Apiliogullari S, Aydogan S. Clinical management of severe propafenone intoxication. J Clin Pract Res 2015;37:119-121.
- Aronson JK, Meyler's Side Effects of Cardiovascular Drugs. Elsevier; 2009.
- American College of Medical Toxicology. ACMT Position Statement: Interim Guidance for the Use of Lipid Resuscitation Therapy. J Med. Toxicol. 2011;7:81-82.
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