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Cardiac Arrest Due to Pacing Failure From Pilsicainide Poisoning
Toshiyuki KishimotoDDS, PhD,
Yoshiaki TakitaniDDS, PhD,
Tomoka Ichikawa,
Kaho ShiraishiDDS,
Hiroki YamadaDDS,
Shoko OyaDDS,
Makoto KumeMD, PhD, and
Satoru SakuraiDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 70: Issue 2
Online Publication Date: Jun 28, 2023
DOI: 10.2344/anpr-69-04-04
Page Range: 70 – 74

We experienced a case of accidental pilsicainide poisoning suspected as the cause of pacing failure leading to cardiac arrest. The patient was a 36-year-old woman with a history of refractory multifocal supraventricular tachycardia who had previously undergone multiple cardiac ablations requiring placement of a pacemaker. Upon her arrival on the day of dental treatment, the patient's condition deteriorated rapidly, with a heart rate of approximately 30 beats/min, pacing failure, and an idioventricular rhythm upon electrocardiographic

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Figure.; A 12-lead electrocardiogram (ECG) obtained soon after the patient's condition initially deteriorated. Idioventricular pattern noted on the ECG along with pacing failure. Heart rate was approximately 30 beats/min. Regularly spaced red arrows indicate pacemaker spikes that were occurring despite lack of capture.
Toshiyuki Kishimoto,
Yoshiaki Takitani,
Tomoka Ichikawa,
Kaho Shiraishi,
Hiroki Yamada,
Shoko Oya,
Makoto Kume, and
Satoru Sakurai
Figure.
Figure.

A 12-lead electrocardiogram (ECG) obtained soon after the patient's condition initially deteriorated.

Idioventricular pattern noted on the ECG along with pacing failure. Heart rate was approximately 30 beats/min. Regularly spaced red arrows indicate pacemaker spikes that were occurring despite lack of capture.