Dikkat! İkinci Derece Mobitz Tip 1 AV Bloğunun Nedenlerinden Biri: Feniramin Maleat

Year 2024, Volume: 16 Issue: 2, 210 - 213, 30.06.2024

Fatih Kurt , Selmin Karademir

https://doi.org/10.18521/ktd.1409133

Abstract

Atrioventriküler (AV) blok, sinoatriyal düğüm (SA düğüm) ile atrioventriküler düğüm (AV düğüm) arasında elektrik iletimini sağlayan yolların işlev kaybıdır. Deformasyon düzeyine göre derecelendirilir.
Birinci derece ve ikinci derece Mobitz tip 1 bloklar genellikle zararsızdır, ancak ikinci derece Mobitz tip 2 bloklarda ve üçüncü derece AV bloklarda hemodinamik istikrarsızlık aniden ve beklenmedik bir şekilde başlayabilir, bayılma veya ani kalp ölümüne neden olabilir.
Myokardit, inferior miyokard enfarktüsü (MI), önceki kalp operasyonları ve beta-blokerler, kalsiyum kanal blokerleri, digoksin ve amiodaron gibi ilaçlarla tedavi, AV blokajına neden olabilir. Bununla birlikte, makalemizde tanımlanan hastada, ürtiker tedavisinde kullandığımız bir antihistamin olan feniramin maleat enjeksiyonu sonrasında bir AV blok gelişti.
Feniramin maleat, alkilamin grubundan birinci nesil, stabil, güçlü, sedatif bir antihistamindir. Feniramin maleatın kardiyak yan etkileri taşikardi ve aritmileri içerir.

Keywords

Aritmi, Feniramin Maleat, Antihistaminik

Ethical Statement

Makalemiz olgu sunumu olduğundan etik kurul onayı almaya gerek görülmemiştir.

Attention! One of the Causes of Second-Degree Mobitz Type 1 AV Block: Pheniramine Maleate

Abstract

Atrioventricular (AV) blockade is the loss of function of the pathways that provide electrical conduction between the sinoatrial node (SA node) and the atrioventricular node (AV node). It is rated according to the level of distortion in the transmission.
First-degree and second-degree Mobitz type 1 blocks are usually benign, but hemodynamic instability in second-degree Mobitz type 2 blocks and third-degree AV blocks can begin suddenly and unexpectedly, causing syncope or sudden cardiac death.
Myocarditis, inferior myocardial infarction (MI), previous heart operation, and treatment with drugs such as beta-blockers, calcium channel blockers, digoxin and amiodarone can cause AV blockade. However, in the patient described in our article, an AV block developed after the injection of pheniramine maleate, an antihistamine we used to treat urticaria.
Pheniramine maleate is a first-generation, stable, potent, sedative, antihistamine from an alkylamine group. The cardiac side effects of pheniramine maleate are tachycardia and arrhythmias.

Keywords

Arrhythmia, Pheniramin Maleat, Antihistamine

Ethical Statement

Our article is a case presentation, and therefore, obtaining ethical approval was deemed unnecessary.

References

• 1. Knabben V, Chhabra L, Slane M. Third-Degree Atrioventricular Block. 2023 Jul 31. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. PMID: 31424783. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545199/
• 2. Sidhu S, Marine JE. Evaluating and managing bradycardia. Trends Cardiovasc Med. 2020;30(5):265-72.
• 3. Shah MJ, Silka MJ, Silva JNA, Balaji S, Beach CM, Benjamin MN, et al. 2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients. Heart Rhythm. 2021;18(11):1888-924.
• 4. Mohamud MFY, Waberi MM. Pheniramine induced supraventricular tachycardia resistant to adenosine: A case report and review. Ann Med Surg (Lond). 2022;78:103621.
• 5. Dyssekilde JR, Christiansen MK, Johansen JB, Nielsen JC, Bundgaard H, Jensen HK. Familial risk of atrioventricular block in first-degree relatives. Heart. 2022;108(15):1194-9.
• 6. Hendriksen S, Karlsen FM, Philbert BT, Person S, Koeber L, Torp-Pedersen C, Bang C. Mobitz type I 2nd degree atrioventricular (Wenckebach) block and cardiovascular death using 978,901 12 lead ECGs recordings, European Heart Journal, Volume 43, Issue Supplement_2, 2022;ehac544.374.
• 7. Doniger DJ, Sharieff GQ. Pediatric dysrhythmias. Pediatr Clin North Am. 2006;53:85-105.
• 8. Park MK. Cardiac arrythmias. In Park MK. Pediatric Cardiology for Practitioners. 5th edn. Mosby Elsevier. 2008;417-48.
• 9. Levi R, Kuye JO. Pharmacological characterization of cardiac histamine receptors: Sensitivity to H1-receptor antagonists. European Journal of Pharmacology. 1974;27(3): 330-8.