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Complete atrioventricular block associated with rivastigmine therapy
Mehmet Kayrak1, Mehmet Yazici, Selim S Ayhan
1Department of Cardiology, Selcuk University Medical Faculty, Konya, Turkey. mehmetkayrak@yahoo.com
Summary
Rivastigmine, a medication for Alzheimer's disease, was associated with complete atrioventricular block in a patient. Discontinuation and reintroduction of rivastigmine confirmed the causal link, necessitating pacemaker implantation.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Alzheimer's disease is a progressive neurodegenerative disorder.
- Rivastigmine is a cholinesterase inhibitor used to treat dementia associated with Alzheimer's disease.
- Cardiovascular adverse events are potential side effects of some dementia medications.
Observation:
- A 67-year-old woman with Alzheimer's disease experienced dizziness and syncope.
- The patient was taking rivastigmine, amlodipine, and nateglinide.
- Initial assessment revealed bradycardia and complete atrioventricular block.
Findings:
- Complete atrioventricular block resolved upon discontinuation of rivastigmine.
- Recurrence of atrioventricular block was observed upon rivastigmine reintroduction.
- Permanent pacemaker implantation was required due to recurrent atrioventricular block.
Implications:
- This case highlights a potential association between rivastigmine and complete atrioventricular block.
- Clinicians should monitor for cardiac adverse events in patients treated with rivastigmine.
- Further investigation into the cardiovascular safety of rivastigmine may be warranted.
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