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Pacing Clin Electrophysiol. 2012 Aug;35(8):e219-21. doi: 10.1111/j.1540-8159.2010.02924.x. Epub 2010 Oct 7.

Isolated tramadol overdose associated with Brugada ECG pattern.

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Hennepin Regional Poison Center, Minneapolis, Minnesota, USA.


Tramadol is a commonly prescribed synthetic opioid analgesic. In humans, electrocardiogram (ECG) changes consistent with sodium-channel blockade have not been described in overdoses with tramadol. We report a case of isolated tramadol overdose associated with a Brugada ECG pattern. A review of the literature reveals no previous human cases of tramadol overdose causing ECG changes consistent with sodium-channel blockade. However, in vitro blockade of sodium-channels has been demonstrated with high concentrations of tramadol. Tramadol overdose should be recognized as a cause for the manifestation of a Brugada ECG pattern in the setting of suicidal intoxication.

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