Ge Chen-Jie, Lei Li-Lei, Wang Shi-Liang, Hu Xu-Qiang
Quality Management Division, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University Huzhou 313000, Zhejiang, China.
Department of Psychiatry, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University Huzhou 313000, Zhejiang, China.
Am J Transl Res. 2025 May 15;17(5):4062-4066. doi: 10.62347/JAKR2090. eCollection 2025.
Third-degree atrioventricular block (AVB) associated with the use of escitalopram and quetiapine is rare, with limited cases reported. We present a case of drug-induced third-degree AVB in an elderly patient undergoing treatment for depression. A 70-year-old woman with a history of depression was initially treated with milnacipran and alprazolam, but the regimen was altered due to insufficient therapeutic response. Two weeks after initiating escitalopram and quetiapine, she developed third-degree AVB. Electrocardiogram (ECG) revealed sinus rhythm with complete AV block, atrioventricular junctional escape rhythm, QT interval prolongation, and a heart rate of 45 bpm. Emergency pacemaker implantation was performed. This case highlights the potential for escitalopram and quetiapine to induce serious cardiac conduction abnormalities, particularly in elderly patients. Regular ECG monitoring is essential when prescribing these agents to minimize the risk of malignant arrhythmia.
与艾司西酞普兰和喹硫平联用相关的三度房室传导阻滞（AVB）较为罕见，报道的病例有限。我们报告一例正在接受抑郁症治疗的老年患者发生药物性三度AVB的病例。一名有抑郁症病史的70岁女性最初接受米氮平和阿普唑仑治疗，但因治疗反应不足而更改治疗方案。在开始使用艾司西酞普兰和喹硫平两周后，她出现了三度AVB。心电图（ECG）显示窦性心律伴完全性房室传导阻滞、房室交界性逸搏心律、QT间期延长，心率为45次/分钟。进行了紧急起搏器植入术。该病例突出了艾司西酞普兰和喹硫平诱发严重心脏传导异常的可能性，尤其是在老年患者中。在开具这些药物处方时，定期进行心电图监测对于将恶性心律失常的风险降至最低至关重要。
