Lacosamide-induced atrial tachycardia in a child with hypoplastic left-heart syndrome: the importance of assessing additional proarrhythmic risks

Abstract

Antiepileptic medications have been reported to cause disturbances in cardiac conduction. Lacosamide decreases seizure burden by modulating sodium channels. Although it has been demonstrated to have few side effects, there have been reports of clinically significant cardiac conduction disturbances. We report the case of a child with hypoplastic left-heart syndrome and well-controlled multifocal atrial tachycardia who developed haemodynamically significant atrial tachycardia after receiving two doses of lacosamide.

Efficacy of lacosamide in children and adolescents with drug-resistant epilepsy and refractory status epilepticus: A systematic review

“…Uncommon objective adverse effects were reported in the SE patients. Only one case of bradycardia (2.5%) [43] and (2.5%) of tachycardia [28] were mentioned within the 40 cases, however not all patients were monitored by EKG at the pediatric intensive care unit.…”

“…Lacosamide is known in the literature by the absence of pharmacokinetic interaction, nevertheless, with only one decade of use, the potential drug-drug interactions are yet to be described. We included one case of plausible interaction between lacosamide and flecainide as substrate for a potential lethal arrhythmia [28]. A recent publication has reported a possible interaction between lacosamide and valproic acid resulting in hyperammonemic encephalopathy [44].…”

Lacosamide cardiac safety: clinical trials in patients with partial-onset seizures

“…There have also been individual cardiac-related AE reports for patients administered lacosamide for non-approved uses. These have included thirddegree AV block in two elderly patients who received lacosamide for the acute treatment of non-convulsive status epilepticus (30,31), and a report of atrial tachycardia in a 3-year-old intensive care unit patient administered lacosamide for subclinical seizures which were observed on EEG (32).…”

A long-term noninterventional safety study of adjunctive lacosamide therapy in patients with epilepsy and uncontrolled partial-onset seizures

“…A small dose-related increase in the PR interval has been observed in trials of oral and intravenous lacosamide, with no significant change in blood pressure or QTc interval [11][12][13][18][19][20]. There have also been some published reports of cardiac AEs in patients receiving lacosamide [9,18,[21][22][23][24][25][26][27][28].…”