Doxepin Overdose: IVCD
Report:
Junctional tachycardia 100/min
Intraventricular conduction delay (IVCD)
QRS 0.16â
Comment:
The QRS duration of 0.16â implies the likelihood of nasty arrhythmias27, but its clinical usefulness is limited by the fact that patients with it need monitoring for shock, coma or convulsions anyway28.
The IVCD induced by tricyclics is usually like this one, nonspecific; some patient may develop or exaggerate fascicular or bundle branch block patterns. The entire QRS is prolonged in this example.
Below (Fig 49a) is the patientâs normal ECG.
Fig 49a. Mild, probably understandable, tachycardia following recovery.
Fig 50. 52 year old lady with dilated left ventricle and EF 29%, following inferolateral infarction and CABGs.
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