Resolution of caffeine-induced complex dysrhythmia with procainamide therapy.

A case report of a 38-year-old male who ingested 20 gm of caffeine is presented. The patient exhibited clinical and laboratory evidence of caffeine toxicity. Cardiac monitoring revealed a chaotic rhythm with variable supraventricular and ventricular dysrhythmias without hemodynamic compromise. Procainamide was used effectively to convert this complex dysrhythmia. The mechanisms, manifestations, and therapy of caffeine toxicity are reviewed.