Key result
Low-dose carbamazepine linked to intermittent complete AV block despite sub-therapeutic serum levels.
Why the study?
Complete atrioventricular block may occur long after initiation of low-dose carbamazepine therapy even with serum concentrations below the therapeutic level in older patients.
Does low-dose carbamazepine cause complete atrioventricular block in older women?
Case Report (n=1)
Does low-dose carbamazepine cause complete atrioventricular block in older women?
Complete atrioventricular block can occur as a late complication of low-dose carbamazepine therapy even at subtherapeutic serum concentrations.
Possible late AV block with low-dose carbamazepine warrants vigilance in older adults; leaves open causal confirmation in prospective studies.
After twelve months of low dose carbamazepine therapy (200 mg daily) for temporal lobe epilepsy, a 66-year-old woman presented to the hospital complaining of frequent episodes of sudden dizziness. Because Holter monitoring documented intermittent complete atrioventricular block, the patient was admitted to the hospital when the serum concentration of carbamazepine was 4 microg/mL. After discontinuation of carbamazepine, the patient returned to normal sinus rhythm. The present case suggests that complete atrioventricular block may occur long after initiation of carbamazepine therapy in an older woman even if the daily dosage or the serum concentration of carbamazepine is low.
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Ide et al. (2007) conducted a case report in Temporal lobe epilepsy (n=1). Carbamazepine was evaluated on Intermittent complete atrioventricular block. A 66-year-old woman developed intermittent complete atrioventricular block after 12 months of low-dose carbamazepine therapy despite sub-therapeutic serum concentrations.
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