Intermittent Atrioventricular Block following Fingolimod Initiation. (5th August 2014)

• Record Type: Journal Article
• Authors: Gialafos, E.; Gerakoulis, S.; Grigoriou, A.; Haina, V.; Kilidireas, C.; Stamboulis, E.; Andreadou, E.
• Other Names: Simone Isabella Laura Academic Editor.
• Is Part Of: Case reports in neurological medicine. Volume 2014(2014)
• Publication Date: 2014-08-05
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; Neurology; Nervous System Diseases; Nervous system -- Diseases; Neurology; Electronic journals; Periodicals; Periodicals; 616.8
• DOI: 10.1155/2014/191305
• Languages: English
• ISSNs: 2090-6676

Abstract

Abstract : 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.