Pregabalin, a synthetic derivate of the inhibitory neurotransmitter γ-aminobutyric acid, shows antiepileptic, analgesic, anticonvulsant, anxiolytic, and
sleep-modulating activities. The major advantage of pregabalin is its relative reliability,
easy use, high tolerance, and lack of negative interaction with other drugs. A 65-year-old
woman with medical histories of diabetes mellitus, lumbar spondylosis, diabetic nephropathy,
chronic renal failure, and anemia of chronic disease was admitted with the complaint
of dizziness and syncope. She had been taking pregabalin 300 mg daily for 8 months.
Electrocardiogram revealed complete atrioventricular (AV) block and right bundle-brunch
block with a heart rate of 39 per minute. Her creatinine was 1.8 mg/dL, and creatinine
clearance was 50 mL/min. Pregabalin treatment was discontinued. Four days later, the
complete AV block resolved spontaneously to Mobitz type II block and to sinus rhythm
with right bundle-brunch block on the seventh day. To our knowledge, this is the first
case of complete AV block associated with pregabalin. We believe that AV block occurred
as a result of pregabalin's effect on L-type Ca++ channels in the heart. Pregabalin's different effects on electrocardiogram and on
the heart in different individuals may have an association with the patterns of distribution
of the L-type calcium channels in myocardium.
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References
- Pregabalin: its pharmacology and use in pain management.Anesth Analg. 2007; 105: 1805-1815
- Gabapentin and pregabalin for chronic neuropathic and early postsurgical pain: current evidence and future directions.Curr Opin Anaesthesiol. 2007; 20: 456-472
- Dominant negative suppression of Rad leads to QT prolongation and causes ventricular arrhythmias via modulation of L-type Ca2+ channels in the heart.Circ Res. 2007; 101: 69-77
- Effects of therapeutic doses of pregabalin on QTc interval in conscious rabbits.Eur Rev Med Pharmacol Sci. 2008; 12: 223-228
- Possible heart failure exacerbation associated with pregabalin: case discussion and literature review.J Cardiovasc Med (Hagerstown). 2008; 9: 922-925
- Decompensation of chronic heart failure associated with pregabalin in patients with neuropathic pain.J Card Fail. 2007; 13: 227-229
- Treatment of pregabalin toxicity by hemodialysis in a patient with kidney failure.Am J Kidney Dis. 2009; 54: 1127-1130
- A case series of recreational pregabalin overdose resulting in generalized seizures.Clin Toxicol. 2010; 48: 616-617
- Pregabalin overdose in adults and adolescents—experience in Sweden.Clin Toxicol. 2010; 48: 282
- Should we care about pregabalin for elderly patients with a history of cardiac dysrhythmia?.Rev Med Interne. 2008; 29: 152-154
- ECG variations in patients pre- and post-local anaesthesia and analgesia.Br Dent J. 2009; 207: E23
Article Info
Publication History
Published online: May 25, 2012
Accepted:
February 15,
2012
Received in revised form:
February 13,
2012
Received:
February 1,
2012
Footnotes
☆The summary of this case report was presented at 6th Congress of Update in Cardiology and Cardiovascular Surgery, in conjunction with 59th International Congress of the European Society for Cardiovascular Surgery, April 15 to 18, 2010, Izmir, Turkey.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
