Lacosamide can induce atrial fibrillation even at a low loading dose of 200 mg, highlighting the need for cardiac history and monitoring in at-risk patients.
May prompt cardiac monitoring with lacosamide initiation in patients with AF risk factors; leaves open true incidence and causality.
Lacosamide (LCM) is a novel antiepileptic drug (AED) approved by the FDA for adjunctive treatment of partial epilepsy with and without secondary generalization. Lacosamide dose-dependent dysrhythmias (PR-interval prolongation, AV block, and atrial fibrillation/flutter) have been reported. This case represents the first instance of LCM-induced atrial fibrillation following a low loading dose (200 mg). Risk factors for atrial fibrillation are addressed and discussed in the context of this case. Full cardiac history is recommended prior to patients being initiated on LCM. Cardiac monitoring may be required for at-risk patients on LCM. Clinicians need to be cognizant of this potential adverse effect.
No takes yet. Share an insight, caveat, or question.
Kaufman et al. (2012) studied this question.