Background: Donepezil is an acetylcholinesterase inhibitor used in Alzheimer's disease management. It improves clinical symptoms but carries risks of orthostatic hypotension and bradycardia. Uncommon severe bradyarrhythmias post-discontinuation deserve attention. In addition, there have been no previous case reports regarding severe bradyarrhythmias post donepezil discontinuation. Case presentation: We report a case of a 33-year-old woman with a history of recurrent fainting. She has dementia and regularly takes donepezil. She experienced severe bradyarrhythmia with heart rate of 45 beats per minute regular on dopamine 5 μg/kg/min and unresponsive to atropine. The discontinuation of donepezil did not improve asymptomatic bradycardia. The use of temporary pacemaker (TPM) improved the patient's condition, then permanent pacemaker (PPM) was implanted. Conclusions: This case report highlights donepezil's link to severe bradyarrhythmia in dementia patients. It stresses the challenges in managing adverse effects, suggesting that stopping donepezil and anticholinergic therapy may not always be sufficient and pacemaker implantation may be required.

• MeSH
• bradykardie * diagnóza   terapie   MeSH
• demence farmakoterapie   komplikace   MeSH
• donepezil * aplikace a dávkování   škodlivé účinky   MeSH
• dospělí MeSH
• elektrokardiografie MeSH
• hrudník diagnostické zobrazování   patologie   MeSH
• kardiostimulace umělá MeSH
• kazuistiky jako téma MeSH
• lidé MeSH
• nenasazení léčby MeSH
• synkopa etiologie   MeSH
• závrať etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH