Rosini Jamie M, Rajasimhan Suraj, Fellows Shawn E, Nomura Jason T
Department of Pharmacy, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE, 19718 USA.
Department of Emergency Medicine, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE, 19718 USA.
Am J Emerg Med. 2015 Jul;33(7):987.e1-3. doi: 10.1016/j.ajem.2014.12.037. Epub 2014 Dec 26.
A 51-year-old woman with relapsing-remitting multiple sclerosis was initiated on fingolimod. She developed a Mobitz Type I (Wenckebach)second-degree atrioventricular (AV) heart block during the initial 6-hour monitoring. She was transferred to the emergency department for further monitoring, where she went into a junctional tachycardia then went back into a Mobitz Type I AV block. The patient was symptomatic with a heart rate nadir of 38 beats per minute and treated with atropine. Junctional tachycardia has not been previously reported with fingolimod use. Patients may require extended cardiac monitoring after fingolimod administration.
一名51岁复发缓解型多发性硬化症女性开始使用芬戈莫德治疗。在最初6小时的监测期间，她出现了莫氏I型（文氏）二度房室传导阻滞。她被转至急诊科进行进一步监测，在那里她出现了交界性心动过速，随后又恢复为莫氏I型房室传导阻滞。患者出现症状，心率最低为每分钟38次，并接受了阿托品治疗。此前尚未有使用芬戈莫德导致交界性心动过速的报道。使用芬戈莫德后患者可能需要延长心脏监测时间。
