Complete atrioventricular block induced by methyldopa

We present two patients who developed complete heart block due to treatment with methyldopa. After discontinuing methyldopa, conduction disturbances completely disappeared and recurred upon rechallenge with the medication. It is assumed that methyldopa can impair the myocardial conduction system by its central sympatholytic effect. Conduction anomalies should be excluded prior to treatment with methyldopa, and during treatment with the medication, the patients should be routinely screened for the presence of conduction anomalies.