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April 27, 2026Acta Medica Alanya0 citationsOpen Access

Complete Atrioventricular Block Induced by Donepezil: A Rare Case Report

HKHalil KoçCKCemal KöseoğluCÖCan Ramazan Öncel

Key Result

Donepezil therapy induced a complete atrioventricular block in an 87-year-old woman, which successfully resolved to sinus rhythm 6 days after drug discontinuation and theophylline treatment.

Key Points

  • To highlight a rare case of complete atrioventricular block associated with donepezil use in an elderly patient.
  • Monitoring an 87-year-old woman on donepezil therapy for cardiac symptoms
  • Treatment with theophylline was administered
  • Observation of spontaneous resolution of AV block following intervention.
  • The patient developed complete atrioventricular block while on donepezil therapy.
  • AV block resolved spontaneously after treatment with theophylline.
  • Demonstrates the risk associated with donepezil in elderly populations.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
87-year-old woman with dementia (n=1) presenting with complete AV block, hyponatremia, and gastrointestinal symptoms, with no known prior cardiac disease.
I
Intervention
Discontinuation of donepezil 10 mg once daily, combined with temporary pacemaker implantation and intravenous theophylline 200 mg twice daily.
O
Outcome
Resolution of complete AV block and restoration of sinus rhythmsafety

Donepezil therapy in elderly patients can rarely induce severe, reversible cardiac conduction disturbances such as complete AV block.

Limitations

  • Concomitant use of Ginkgo biloba extract, which may have cardiovascular effects and potential drug interactions

Abstract

Donepezil, a reversible acetylcholinesterase inhibitor that increases parasympathetic activity by enhancing cholinergic tone, is used to preserve cognitive function in patients with Alzheimer’s disease. However, donepezil may slow conduction, particularly at the sinoatrial and atrioventricular nodes, which increases the risk of bradycardia, sinus arrest, or high-grade AV block, particularly in elderly or comorbid patients. Complete AV block is rarely seen with donepezil use. Herein, we present a case of complete AV block in an 87-year-old woman receiving donepezil therapy, which resolved spontaneously following theophylline treatment.

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Cite This Study

Koç et al. (2026) conducted a case report in Complete Atrioventricular Block (n=1). Donepezil was evaluated. Donepezil therapy induced a complete atrioventricular block in an 87-year-old woman, which successfully resolved to sinus rhythm 6 days after drug discontinuation and theophylline treatment.

synapsesocial.com/papers/69eefdb5fede9185760d4648https://doi.org/10.30565/medalanya.1825751
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