Prognosis and natural history of drug-related bradycardia.

Korean Circulation Journal
Jang Hoon LeeWee-Hyun Park

Abstract

The prognosis and natural history of bradycardia related to drugs such as beta-blockers and non-dihydropyridine calcium channel blockers are not well known. We retrospectively analyzed 38 consecutive patients (age 69+/-11, 21 women) with drug-related bradycardia (DRB) between March 2005 and September 2007. A drug-associated etiology for the bradycardia was established based on the medical history and patient response to drug discontinuation. The mean follow-up duration was 18+/-8 months. The initial electrocardiogram (ECG) showed sinus bradycardia (heart rate </=40/min) in 13 patients, sinus bradycardia with junctional escape beats in 18 patients, and third-degree atrioventricular (AV) block in seven patients. Drug discontinuation was followed by resolution of bradycardia in 60% of patients (n=23). Among them, five (17.8%) patients resumed taking the culprit medication after discharge and none developed bradycardia again. Bradycardia persisted in 10 (26.3%) patients despite drug withdrawal, and a permanent pacemaker was implanted in seven of them. Third-degree AV block, QRS width, and bradycardia requiring temporary transvenous pacing were significantly associated with the bradycardia caused by drugs. Beta-blockers were the mos...Continue Reading

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Citations

Oct 16, 2010·Pacing and Clinical Electrophysiology : PACE·Yu-Lan JouShih-Ann Chen
Jul 19, 2011·The Journal of Clinical Hypertension·Joel Handler
Jul 23, 2013·Journal of Cardiovascular Electrophysiology·Maria Bisgaard KnudsenSam Riahi
Apr 26, 2012·Pacing and Clinical Electrophysiology : PACE·Damirbek OsmonovKadir Gurkan
Jul 25, 2019·Journal of the American Geriatrics Society·Frederik DalgaardMartin H Ruwald
Apr 2, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Taishi OkunoUNKNOWN J-MINUET Investigators

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