Third-degree sinoatrial block

Cardiovascular A woman taking losartan 25 mg/day and carbamazepine was admitted to hospital with head trauma secondary to syncope her heart rate was 30/minute and her serum potassium concentration 6.7 mmol/1 [53 ]. It was suspected that the hyperkalemia was associated with losartan, leading to third-degree sinoatrial block or complete sinus arrest. 

Contraindications Hydantoin hypersensitivity, seizures due to hypoglycemia, Adam-Stokes syndrome, second- and third-degree heart block, sinoatrial block, sinus bradycardia... 

Do not use in sinus bradycardia, sinoatrial block, second- and third-degree AV block, or in patients with Adams-Stokes syndrome. 

A. With acute overdose, vomiting, hyperkalemia, sinus bradycardia, sinoatrial arrest, and second- or third-degree AV block are common. Ventricular tachycardia or fibrillation may occur. 

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