Karlberg (67) and German Kaymer (70) ended the tournament with matching 19-under totals of 269 before the Swede took the title by birdying the second playoff hole.
"It feels amazing to get my first win and it has been a pretty crazy year for me," he told reporters at Golf Club Milano. "I got married and now my wife is expecting twins in December.
"I thought I had a good chance this week because I have been playing very well lately. To win against a player as good as Martin in sudden-death makes it very special."
Seven players tied for third place on 270 -- Swedes Joakim Lagergren and Jens Fahrbring, British pair Matt Fitzpatrick and Danny Willett, Paraguay's Fabrizio Zanotti, American David Lipsky and Dane Lucas Bjerregaard.
(Writing by Tony Jimenez,; editing by Pritha Sarkar)
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