Carbamazepine-induced sinus node dysfunction and atrioventricular block in elderly women
K Takayanagi1, I Hisauchi, J Watanabe
1Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Japanese Heart Journal
|November 12, 1998
Summary
Carbamazepine may cause heart rhythm problems like bradyarrhythmia in elderly women. Discontinuing the drug resolved these issues, suggesting careful monitoring is needed.
Area of Science:
- Cardiology
- Clinical Pharmacology
Background:
- Carbamazepine is commonly prescribed for trigeminal neuralgia and epilepsy.
- Elderly patients may be more susceptible to adverse drug reactions.
Observation:
- Four elderly women developed bradyarrhythmia (sinus node dysfunction or atrioventricular block) during carbamazepine therapy.
- Cardiac conduction disturbances resolved upon carbamazepine withdrawal.
Findings:
- Provocation tests confirmed carbamazepine-induced sinus arrest in two patients.
- Computer simulations revealed a correlation between carbamazepine plasma concentration and sinus arrest frequency.
- One patient with renal insufficiency had decreased carbamazepine clearance.
Implications:
- Close electrocardiogram (ECG) and plasma drug monitoring are recommended during carbamazepine treatment.
- Particular caution is advised for elderly women receiving carbamazepine.
- Understanding carbamazepine's cardiac effects is crucial for patient safety.
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