ECG findings complicate drug treatment of memory disorders
Background Anti-dementia drugs have potential cardiac effects, but clinicians’ practices regarding ECG interpretation in the treatment of memory disorders have not been studied. International guidelines have not delineated which ECG findings should be contraindications for initiating anti-dementia medication.
Methods Clinicians’ views on which ECG changes are contraindications for initiating treatment with acetylcholinesterase inhibitors (AChEIs) were collected with a web-based questionnaire.
Results A total of 157 physicians responded to the survey. Of these, 71% were geriatricians. More than half (63%) of the physicians experienced that ECG changes complicated treatment at least to some extent. The findings most commonly considered contraindications for AChEI initiation or dose increase were second-degree AV block (90% and 85%, respectively) and sinus bradycardia (84% and 86%, respectively), but the responses showed considerable variation. Neither special competence in the treatment of memory disorders (p = 0.06), the patient’s age (p = 0.25) nor comorbidities (p = 0.07) affected whether the ECG was always evaluated before initiating AChEI medication.
Conclusions Our findings indicate considerable divergence in physicians’ opinions on which ECG changes are contraindications for AChEIs. The importance of ECG changes for AChEI treatment warrants further research.
Salla Ranta, Ville Langén, Maria Nuotio, Laura Ekblad
Salla Ranta
B.M.
University of Turku, Faculty of Medicine
