Key result
Donepezil discontinuation and theophylline restore sinus rhythm in complete AV block induced by the medication.
Why the study?
Donepezil may slow conduction and increase bradyarrhythmia risk, but complete AV block is rarely seen.
Case Report (n=1)
No
Donepezil therapy in elderly patients can rarely induce severe, reversible cardiac conduction disturbances such as complete AV block.
Supports clinical caution for bradyarrhythmias with donepezil in elderly; leaves open incidence of complete AV block pending further research.
Donepezil, a reversible acetylcholinesterase inhibitor that increases parasympathetic activity by enhancing cholinergic tone, is used to preserve cognitive function in patients with Alzheimer’s disease. However, donepezil may slow conduction, particularly at the sinoatrial and atrioventricular nodes, which increases the risk of bradycardia, sinus arrest, or high-grade AV block, particularly in elderly or comorbid patients. Complete AV block is rarely seen with donepezil use. Herein, we present a case of complete AV block in an 87-year-old woman receiving donepezil therapy, which resolved spontaneously following theophylline treatment.
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Koç et al. (2026) conducted a case report in Complete Atrioventricular Block (n=1). Donepezil was evaluated. Donepezil therapy induced a complete atrioventricular block in an 87-year-old woman, which successfully resolved to sinus rhythm 6 days after drug discontinuation and theophylline treatment.
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