2025 Volume 16 Issue 1 Pages 44-46
A 66-year-old man underwent implantation of an implantable cardioverter defibrillator for syncope attacks due to sustained ventricular tachycardia. He was taking 300 mg/day cibenzoline succinate (CZ) to treat paroxysmal atrial fibrillation and hypertrophic cardiomyopathy. Two weeks previously he presented to our hospital complaining of appetite loss, increased general malaise, and difficulty with physical activity. He was admitted with hypoglycemia, marked prolongation of the QRS wave on ECG, severe renal dysfunction, and myasthenia gravis-like symptoms. His blood CZ level was 2,591 ng/mL and he was diagnosed with CZ poisoning. The patient presented with metabolic acidosis that could not be corrected with sodium bicarbonate injections and was complicated by acute kidney injury. Therefore, continuous hemodiafiltration (CHDF) was initiated. Various complications improved following early implementation of CHDF, resulting in a good course of treatment. The patient was discharged after confirming that his blood CZ level had reached normal level.
