Leentjens_2006_Ned.Tijdschr.Geneeskd_150_563

A 77-year-old man who for 5 months had been being treated with galantamine for early Alzheimer's disease, suddenly became unwell. He was bradycardic and his ECG showed a complete atrioventricular block. This was treated by implantation of a pacemaker. Treatment with galantamine was continued. A month later he had no cardiac symptoms and his dementia score on a cognitive scale had improved. Cholinesterase inhibitors may have adverse effects on the heart. Patients starting treatment with cholinesterase inhibitors should be screened for an increased risk of cardiac arrhythmias by investigating their potassium concentrations and running an ECG.