[Effects of carbamazepine on heart conduction in young patients: a serial study using ambulatory ECG].
BACKGROUND
Carbamazepine (CBZ) is a first-line drug in the treatment of epileptic seizures and neuralgia. CBZ is also a cardioactive drug and sometimes induces sinusal dysfunction or AV conduction defects.


METHODS
In order to investigate the effect of CBZ on sinus node function and AV conduction, long-term ECG recording (24 hours) and determination of plasma concentration of CBZ were carried out in 10 epileptic patients without heart disorders (5 males and 5 females, mean age 31 years), in the basal state, during steady-state (7th day) and after 30th day of CBZ treatment. The number of total cardiac beats, mean heart rate, P-Q and Q-T interval, sinus-atrial node and atrioventricular dysfunction and intraventricular conduction delay were evaluated.


RESULTS
Plasma CBZ concentration was always in the therapeutic range (5-12 micrograms/ml): 9.5 micrograms/ml in the 7th day and 7.8 micrograms/ml in the 30th day. No significant differences in the number of cardiac beats, or P-Q and Q-T intervals were found; there was no depression of sinus node function nor delay of AV conduction. In the basal state, ectopic supraventricular beats (105 +/- 20/24 hours) were observed in 7 patients and repetitive in five of them. In the first Holter ECG recording during CBZ treatment, a strong reduction of ectopic supraventricular beats (6 +/- 3/24 hours) and disappearance of the bursts was observed. In the second control, when the CBZ concentration was lower, the number of ectopic supraventricular beats were moderately increased (30 +/- 8/24 hours) and in one patient supraventricular tachycardia reappeared.


CONCLUSIONS
In young epileptic subjects without signs of heart disease, CBZ seems to have no significant effect on conduction, yet has a possible antiarrhythmic effect.
Matteoli
S
S
Clinica Medica II, Università degli Studi La Sapienza, Roma.
Trappolini
M
M
Curione
M
M
Fanari
F
F
Borgia
M C
MC
Puletti
M
M
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000517:prevention & control; D002220:Carbamazepine / Q000097:blood / Q000627:therapeutic use*; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged
D002220:Carbamazepine
Effetti della carbamazepina sull'eccitoconduzione cardiaca in soggetti giovani: studio seriato con ECG-dinamico.