title: Bradyarrhythmias secondary to topical levobunolol hydrochloride solution.
abstract: An 88-year-old man was admitted with fatigue, dizziness, and heart palpitations. Both the electrocardiogram and Holter confirmed the existence of sinus bradycardia and sinus arrest. One hour prior to the onset of symptoms, he received levobunolol hydrochloride solution topically. The levobunolol hydrochloride solution was discontinued and the bradycardia resolved. He was diagnosed as having intermittent sinus bradycardia and sinus arrest, induced by topical β-blocker therapy. Levobunolol hydrochloride solution is an effective therapy for ocular hypertension, probably by reducing aqueous fluid production. However, it can induce cardiac side effects such as bradyarrhythmia and should be used with caution in elderly patients or patients with cardiac disease.
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Lianjun
authors.initials: L
authors.lastname: Lin
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Yuchuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Meilin
authors.initials: M
authors.lastname: Liu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000369:Aged, 80 and over; D001919:Bradycardia / Q000139:chemically induced* / Q000175:diagnosis; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D002040:Levobunolol / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D009798:Ocular Hypertension / Q000188:drug therapy*; D009883:Ophthalmic Solutions; D054138:Sinus Arrest, Cardiac / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D002040:Levobunolol
keywords: bradycardia; glaucoma; the elderly; topical β-blocker