Abstract
The prevalence of overactive bladder (OAB) increases with age and can be associated with other co-morbidities, such as cardiac arrhythmia. Unfortunately, commonly used anticholinergic drugs for OAB can affect the cardiovascular system, leading to tachycardia. However, there are no data, which consider the influence of intradetrusor onabotulinumtoxinA injections on heart function in idiopathic OAB patients. The aim of the present study was to evaluate the influence of intradetrusor onabotulinumtoxinA injections on electrocardiogram (ECG) parameters. Additionally, changes in ECG were analyzed in OAB patients without cardiac arrhythmia. Thirty-one patients with cardiac arrhythmia and 31 participants without irregular heart rate (HR) completed the study. ECG measurements were performed in supine positions 2 h before onabotulinumtoxinA injections, 1 h after treatment, and at 2 weeks of follow-up. At week 6, a phone-call survey was conducted to collect data about adverse events. OnabotulinumtoxinA injections were performed with rigid cystoscopy under local anesthesia. We did not observe any clinically significant changes in the analyzed ECG parameters between consecutive measurements. While a slight increase of HR was observed in patients without cardiac arrhythmia, it remained within normal range. Intravesical onabotulinumtoxinA injections are, hence, safe for female patients with cardiac arrhythmia and do not significantly influence changes in ECG.
Highlights
Overactive bladder (OAB) has a complex set of symptoms, such as urgency, frequency, nocturia, and urge incontinence, which can significantly affect one’s quality of life [1]
Due to the fact that muscarinic receptors are distributed throughout the whole body, antimuscarinic drugs present many side effects, including those concerning the heart [7]
To the best of our knowledge, this study is the first to investigate the influence of onabotulinumtoxinA injections on heart function in overactive bladder (OAB) patients with cardiac arrhythmia
Summary
Overactive bladder (OAB) has a complex set of symptoms, such as urgency, frequency, nocturia, and urge incontinence, which can significantly affect one’s quality of life [1]. Ageing affects the cardiovascular system and can lead to heart disorders and arrhythmia, and supraventricular premature beats are observed in 5–10% of all individuals older than 60 years, while atrial fibrillation can affect 6% of those >65 years [3]. Prescribing pharmacotherapy for OAB treatment should include recognizing their potential influence on the cardiovascular system. The main treatment method and first-line pharmacological options for OAB are antimuscarinic drugs and mirabegron. Intradetrusor injections of onabotulinumtoxinA are approved as a second line of pharmacological treatment for OAB [4,5]. Antimuscarinic drugs and mirabegron are considered to be highly effective [6]. Due to the fact that muscarinic receptors are distributed throughout the whole body, antimuscarinic drugs present many side effects, including those concerning the heart [7]. The most common adverse events (AEs) are dry mouth, constipation, dry eyes, blurred vision, dizziness, and tachycardia [8]
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