What QRS duration may predict a risk of seizure in TCA overdose?
According to the cited reference, determination of the maximal limb-lead QRS duration predicts the risk of seizures and ventricular arrhythmias in acute overdose with tricyclic antidepressants. In this study, patients with QRS duration greater than 100 ms had a 34% incidence of seizures.
Boehnert MT, Lovejoy FH Jr. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. N Engl J Med. 1985 Aug 22;313(8):474-9. doi: 10.1056/NEJM198508223130804. PMID: 4022081.
Contributed by Makayla Beecham, MD, PGY-1 emergency medicine resident at Ohio State University Wexner Medical Center
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