SHM Converge Scientific Abstract ePoster Gallery-Slowing the Heart, to Beat the Flu? Uncovering Bradycardia After the Use of Oseltamivir

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This case report describes a 34-year-old woman with chronic hypertension, paraplegia from a prior motor vehicle accident, and substance use disorder who was admitted with persistent tachycardia and tested positive for influenza. Her initial ECG showed sinus tachycardia. Because other common causes were not supported—thyroid tests were normal, echocardiogram was normal, and autonomic dysfunction from spinal cord injury would typically cause sinus tachycardia—oseltamivir was considered as a possible contributor due to the timing of her rhythm changes.<br /><br />After oseltamivir exposure, serial ECGs showed evolving rhythm abnormalities, including junctional bradycardia and sinus bradycardia, before later returning to sinus tachycardia after the drug was discontinued. The heart rate normalized following cessation of oseltamivir, supporting a likely medication-related effect. She was also treated for chronic osteomyelitis and discharged home.<br /><br />The discussion notes that neuraminidase inhibitors such as oseltamivir are widely used for influenza and are generally well tolerated, but cardiovascular adverse effects can occur, including tachyarrhythmias, QT prolongation, and in rare cases bradycardia or other arrhythmias. The exact mechanism is unclear, though it may involve effects on atrial action potential duration.<br /><br />The main conclusion is that oseltamivir-induced bradycardia, though rare, is clinically important. New rhythm disturbances after starting oseltamivir should prompt consideration of a medication-induced arrhythmia, and telemetry monitoring may help detect these changes early.

Asset Subtitle

Vinuri U. Goonesinghe

Meta Tag

Author List Lincy Philip, Neel Patel, Pranav Patel, Rakan Al-Ahmad, Sri Harshini Gandhamaneni, Vinuri U. Goonesinghe

Category Clinical Vignettes

Concept Oseltamivir

Concept Bradycardia

Concept Oseltamivir-Associated Bradycardia

Concept Cardiac Arrhythmia

Concept Drug-Induced Arrhythmia

Distinguished Non-Finalist

Presenter Organization Inspira Medical Center Mullica Hill, NJ

Presenting Author Vinuri U. Goonesinghe

Track Adult

Keywords

oseltamivir

bradycardia

arrhythmia

influenza

sinus tachycardia

junctional bradycardia

ECG

telemetry monitoring

neuraminidase inhibitor

medication-induced arrhythmia

Oseltamivir

Bradycardia

Oseltamivir-Associated Bradycardia

Cardiac Arrhythmia

Drug-Induced Arrhythmia