Cardiac complications following tricyclc antidepressant overdose

Abstract

Poisoning with tricyclic antidepressant agents (TCA) may cause myocardial depression and ventricular arrhythmias. Treatment of these arrhythmias is based on adequate supportive therapy and administration of sodium bicarbonate. Specific anti-arrhythmic agents are sometimes required but the choice of drug is complicated by the fact that many agents cause myocardial depression and can be proarrhythmogenic. We present a case of TCA overdose with recurrent ventricular fibrillation despite supportive treatment and sodium bicarbonate administration, and discuss the actions of available antidysrhythmic drugs.