Severe cardiac toxicity following alcohol intake in a patient using therapeutic dose of propafenone

An unconscious, 25-year-old, male patient was brought to the emergency department. The patient’s electrocardiography demonstrated a wide QRS interval and first-degree atrioventricular block. He was being treated with propafenone twice daily (450 mg) for paroxysmal atrial fibrillation. The patient had consumed a substantial amount of alcohol the day before. He recovered after supportive management with sodium bicarbonate and inotropic therapy. In the presently described case, treatment resulted in quick normalization of QRS interval and stabilization of hemodynamic status.