Reactions 1680, p129 - 2 Dec 2017
Sick sinus syndrome, complete atrioventricular
block and junctional escape rhythm: case report
A 38-year-old woman developed sick sinus syndrome,
complete atrioventricular block and junctional escape rhythm
during treatment with ergometrine [ergonovine].
The woman, who had primary infertility, received in vitro
fertilisation. A routine transvaginal ultrasonography at follow-
up revealed swelling in the right adnexa without intrauterine
embryo. The right adnexa mass was regarded as a
hydrosalpinx after an exploratory laparoscopy. Following
laparoscopic surgery, vaginal bleeding occurred.
Consequently, she received therapy with oral ergometrine
0.2mg thrice a day to facilitate uterine contraction, under the
impression of complete abortion. After the fourth dose, she
developed mild chest tightness and general weakness.
However, a complete AV block presenting with type 1 and
type 2 second-degree sino-atrial exit block and junctional
escape rhythm were revealed by an ECG. Ergometrine was
suspected to be the cause of her transient sick sinus syndrome
and complete AV block with junctional space rhythm.
The woman received conservative treatment. Bed rest was
suggested to her. Ergometrine was withdrawn. Her sinus
rhythm recovered one day after ergometrine discontinuation.
She remained asymptomatic after the recovery of sinus
Author comment: "The Naranjo adverse drug reaction
(ADR) causality score was 5, which represented probable ADR
of ergonovine in this case."
Wang HT, et al. Transient sick sinus syndrome with complete atrioventricular
block associated with ergonovine intake: A case report. Medicine 96: e8559, No.
44, Nov 2017. Available from: URL: http://doi.org/10.1097/
MD.0000000000008559 - Taiwan
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved