Intermittent Atrioventricular Block following Fingolimod Initiation

A 47-year-old female patient with multiple sclerosis (MS) developed symptomatic intermittent 2nd degree atrioventricular block (AVB) of five-hour duration, five hours after the first two doses of fingolimod, that resolved completely. Frequency domain analysis of heart rate variability (HRV) revealed...

Descripción completa

Detalles Bibliográficos
Autores principales: Gialafos, E., Gerakoulis, S., Grigoriou, A., Haina, V., Kilidireas, C., Stamboulis, E., Andreadou, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138951/
https://www.ncbi.nlm.nih.gov/pubmed/25161784
http://dx.doi.org/10.1155/2014/191305
_version_ 1782331304664104960
author Gialafos, E.
Gerakoulis, S.
Grigoriou, A.
Haina, V.
Kilidireas, C.
Stamboulis, E.
Andreadou, E.
author_facet Gialafos, E.
Gerakoulis, S.
Grigoriou, A.
Haina, V.
Kilidireas, C.
Stamboulis, E.
Andreadou, E.
author_sort Gialafos, E.
collection PubMed
description A 47-year-old female patient with multiple sclerosis (MS) developed symptomatic intermittent 2nd degree atrioventricular block (AVB) of five-hour duration, five hours after the first two doses of fingolimod, that resolved completely. Frequency domain analysis of heart rate variability (HRV) revealed increased parasympathetic activity and decreased sympathetic tone, while modified Ewing tests were suggestive of impaired cardiac sympathetic function. We hypothesize that expression of this particular arrhythmia might be related to autonomic nervous system (ANS) dysfunction due to demyelinating lesions in the upper thoracic spinal cord, possibly augmented by the parasympathetic effect of the drug.
format Online
Article
Text
id pubmed-4138951
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-41389512014-08-26 Intermittent Atrioventricular Block following Fingolimod Initiation Gialafos, E. Gerakoulis, S. Grigoriou, A. Haina, V. Kilidireas, C. Stamboulis, E. Andreadou, E. Case Rep Neurol Med Case Report A 47-year-old female patient with multiple sclerosis (MS) developed symptomatic intermittent 2nd degree atrioventricular block (AVB) of five-hour duration, five hours after the first two doses of fingolimod, that resolved completely. Frequency domain analysis of heart rate variability (HRV) revealed increased parasympathetic activity and decreased sympathetic tone, while modified Ewing tests were suggestive of impaired cardiac sympathetic function. We hypothesize that expression of this particular arrhythmia might be related to autonomic nervous system (ANS) dysfunction due to demyelinating lesions in the upper thoracic spinal cord, possibly augmented by the parasympathetic effect of the drug. Hindawi Publishing Corporation 2014 2014-08-05 /pmc/articles/PMC4138951/ /pubmed/25161784 http://dx.doi.org/10.1155/2014/191305 Text en Copyright © 2014 E. Gialafos et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Gialafos, E.
Gerakoulis, S.
Grigoriou, A.
Haina, V.
Kilidireas, C.
Stamboulis, E.
Andreadou, E.
Intermittent Atrioventricular Block following Fingolimod Initiation
title Intermittent Atrioventricular Block following Fingolimod Initiation
title_full Intermittent Atrioventricular Block following Fingolimod Initiation
title_fullStr Intermittent Atrioventricular Block following Fingolimod Initiation
title_full_unstemmed Intermittent Atrioventricular Block following Fingolimod Initiation
title_short Intermittent Atrioventricular Block following Fingolimod Initiation
title_sort intermittent atrioventricular block following fingolimod initiation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138951/
https://www.ncbi.nlm.nih.gov/pubmed/25161784
http://dx.doi.org/10.1155/2014/191305
work_keys_str_mv AT gialafose intermittentatrioventricularblockfollowingfingolimodinitiation
AT gerakouliss intermittentatrioventricularblockfollowingfingolimodinitiation
AT grigorioua intermittentatrioventricularblockfollowingfingolimodinitiation
AT hainav intermittentatrioventricularblockfollowingfingolimodinitiation
AT kilidireasc intermittentatrioventricularblockfollowingfingolimodinitiation
AT stamboulise intermittentatrioventricularblockfollowingfingolimodinitiation
AT andreadoue intermittentatrioventricularblockfollowingfingolimodinitiation

Ejemplares similares