Complete Atrioventricular Block Induced by Donepezil: A Rare Case Report

Donepezil, a reversible acetylcholinesterase inhibitor that increases parasympathetic activity by enhancing cholinergic tone, is used to preserve cognitive function in patients with Alzheimer’s disease. However, donepezil may slow conduction, particularly at the sinoatrial and atrioventricular nodes, which increases the risk of bradycardia, sinus arrest, or high-grade AV block, particularly in elderly or comorbid patients. Complete AV block is rarely seen with donepezil use. Herein, we present a case of complete AV block in an 87-year-old woman receiving donepezil therapy, which resolved spontaneously following theophylline treatment.