Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I understand your concern and would explain that Wenckebach arrhythmia is a very specific condition.

I would like to review your ECG reports if you can upload them for a second professional opinion.

Regarding the medication that you are taking, I would explain that no one of these drugs has been related to this type of cardiac arrhythmia.

Tramol from data evidence has shown to induce ECG changes and tachycardia.

How have you noticed Wenckebach arrhythmia during these drugs intake?

I would recommend performing further tests to invetigate for cardiac arrythmia and the possible causes:

- a cardiac ultrasound to examine your cardiac function and structure
- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends for a prolonged time and detect possible cardiac arrhythmia
- a cardiac stress test to investigate for possible coronary artery disease underlying this disorder
- blood electrolytes for possible electrolytes imbalances
- thyroid hormone levels for possible thyroid dysfucntion
- Myocarditis-related laboratory studies (eg, Lyme titers, HIV serologies, enterovirus polymerase chain reaction [PCR], adenovirus PCR, Chagas titers), if suspicions of myocarditis are raised.

Diagnostic electrophysiologic testing can help determine the level of the block and the potential need for a permanent pacemaker.

Regarding Lyrica, differently from the other drugs (which are symptomatic relief drugs used for a short term therapy), it can be used for a prolonged time in chronic pain with a high efficacy.

There is no data evidence base to support any possible relation between Lyrica intake and this type of cardiac arrhythmia. I would recommend trying again this drug, but starting with low doses and increasing slowly in order to avoid possible adverse effects.

Another drug I would recommend for chronic pain management (if you do not tolerate Lyrica), is gabapentine.

It is another antiepileptic drug (the same pharmacological class as Lyrica), which is used for chronic pain, but with a lower efficacy than Lyrica.

So I would not recommend avoiding these drugs (except for Tramol), in managing your pain.

You should discuss with your doctor on the above mentioned tests, in order to investigate for the possible causes and the severity of your cardiac arrhythmia.

Hope to have been helpful!

Kind regards,

Dr. Iliri

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