DESCRIPTION:
- Ventricular rate 100 bpm
- Sinus rhythm
- PR interval 194 ms
- QRS axis (-67°)
- QRS duration 138 ms
- R’ wave > 3 mm and R/S ration > 0.7 in aVR
- QTc 518 ms
INTERPRETATION:
- Progressive and worsening sodium channel blockade.
- Collateral history revealed patient was prescribed dothiepin.
- Shortly after this ECG was taken the patient had a generalised tonic-clonic seizure, however with subsequent effective management of tricyclic antidepressant (TCA) poisoning the patient made a complete recovery.
See LITFL for further information on the electrocardiographic features of TCA overdose.
