Intermittent Atrioventricular Block following Fingolimod Initiation | Zendy

Elias Gialafos | Zendy; Stathis Gerakoulis | Zendy; Asimina Grigoriou | Zendy; V. Haina | Zendy; Constantinos Kilidireas | Zendy; Elefterios Stamboulis | Zendy; Elisabeth Andreadou | Zendy

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Intermittent Atrioventricular Block following Fingolimod Initiation

Author(s) -

Elias Gialafos,

Stathis Gerakoulis,

Asimina Grigoriou,

V. Haina,

Constantinos Kilidireas,

Elefterios Stamboulis,

Elisabeth Andreadou

Publication year - 2014

Publication title -

case reports in neurological medicine

Language(s) - English

Resource type - Journals

eISSN - 2090-6668

pISSN - 2090-6676

DOI - 10.1155/2014/191305

Subject(s) - medicine , fingolimod , atrioventricular block , cardiology , multiple sclerosis , autonomic nervous system , heart rate variability , heart rate , baroreflex , anesthesia , parasympathetic nervous system , blood pressure , immunology

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.

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