Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete
Lacosamide enhances slow inactivation of voltage-gated sodium channels and can lead to dose-dependent PR interval prolongation. Previously, lacosamide has been associated with second-degree atrioventricular (AV) heart block in the context of multiple medical comorbidities and/or in the elderly with...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Epilepsy & Behavior Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986420300204 |
| _version_ | 1818640285852237824 |
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| author | Brian Stamm Atif Sheikh Stephan Schuele Jessica W. Templer |
| author_facet | Brian Stamm Atif Sheikh Stephan Schuele Jessica W. Templer |
| author_sort | Brian Stamm |
| collection | DOAJ |
| description | Lacosamide enhances slow inactivation of voltage-gated sodium channels and can lead to dose-dependent PR interval prolongation. Previously, lacosamide has been associated with second-degree atrioventricular (AV) heart block in the context of multiple medical comorbidities and/or in the elderly with multimorbidity on other dromotropic agents. We report a case of second-degree AV block occurring in a healthy, athletic young adult. The patient had baseline bradycardia with no known cardiac comorbidities. He was exquisitely sensitive to lacosamide with EKG and telemetry changes developing on the order of hours after receiving intravenous lacosamide. Lacosamide was subsequently stopped, the second-degree AV block was no longer present and EKG returned to baseline. We hypothesize that his sensitivity to lacosamide-induced AV block was possibly secondary to his baseline bradycardia with early repolarization changes. The case underscores the importance of surveillance cardiac monitoring. While medical comorbidities and an older age may portend a greater risk of PR prolongation, routine EKGs should be considered in all patients receiving lacosamide. |
| first_indexed | 2024-12-16T23:08:51Z |
| format | Article |
| id | doaj.art-10a58375a2d44427b6576be213c4d0db |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-12-16T23:08:51Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-10a58375a2d44427b6576be213c4d0db2022-12-21T22:12:28ZengElsevierEpilepsy & Behavior Reports2589-98642020-01-0114100372Lacosamide-associated second-degree atrioventricular block in a healthy, young athleteBrian Stamm0Atif Sheikh1Stephan Schuele2Jessica W. Templer3Corresponding author at: Northwestern Memorial Hospital, 251 E Huron St, Chicago, IL 60611, United States.; Northwestern University Feinberg School of Medicine, Department of Neurology, Chicago, IL 60611, United StatesNorthwestern University Feinberg School of Medicine, Department of Neurology, Chicago, IL 60611, United StatesNorthwestern University Feinberg School of Medicine, Department of Neurology, Chicago, IL 60611, United StatesNorthwestern University Feinberg School of Medicine, Department of Neurology, Chicago, IL 60611, United StatesLacosamide enhances slow inactivation of voltage-gated sodium channels and can lead to dose-dependent PR interval prolongation. Previously, lacosamide has been associated with second-degree atrioventricular (AV) heart block in the context of multiple medical comorbidities and/or in the elderly with multimorbidity on other dromotropic agents. We report a case of second-degree AV block occurring in a healthy, athletic young adult. The patient had baseline bradycardia with no known cardiac comorbidities. He was exquisitely sensitive to lacosamide with EKG and telemetry changes developing on the order of hours after receiving intravenous lacosamide. Lacosamide was subsequently stopped, the second-degree AV block was no longer present and EKG returned to baseline. We hypothesize that his sensitivity to lacosamide-induced AV block was possibly secondary to his baseline bradycardia with early repolarization changes. The case underscores the importance of surveillance cardiac monitoring. While medical comorbidities and an older age may portend a greater risk of PR prolongation, routine EKGs should be considered in all patients receiving lacosamide.http://www.sciencedirect.com/science/article/pii/S2589986420300204EpilepsyPR prolongationLacosamideHeart blockArrhythmia |
| spellingShingle | Brian Stamm Atif Sheikh Stephan Schuele Jessica W. Templer Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete Epilepsy & Behavior Reports Epilepsy PR prolongation Lacosamide Heart block Arrhythmia |
| title | Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete |
| title_full | Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete |
| title_fullStr | Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete |
| title_full_unstemmed | Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete |
| title_short | Lacosamide-associated second-degree atrioventricular block in a healthy, young athlete |
| title_sort | lacosamide associated second degree atrioventricular block in a healthy young athlete |
| topic | Epilepsy PR prolongation Lacosamide Heart block Arrhythmia |
| url | http://www.sciencedirect.com/science/article/pii/S2589986420300204 |
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