Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug

Zeltser, David; Justo, Dan; Halkin, Amir; Rosso, Raphaël; Ish‐Shalom, Maya; Hochenberg, Mordechai; Viskin, Sami

doi:10.1016/j.jacc.2004.03.057

Cited by 117 publications

(89 citation statements)

References 7 publications

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“…Only 15% of patients who had second or third degree AV block during therapy with β-blockers, verapamil, or diltiazem was "truly caused by drugs". [34] A study by Lee, et al [35] found that β-blockers were the most common drugs associated with drug-related bradycardia (DRB). In this study, drug discontinuation was followed by resolution of bradycardia in 60% of patients.…”

Section: Discussionmentioning

confidence: 99%

Beta-Blocker Use and Risk of Symptomatic Bradyarrhythmias: A Hospital-Based Case-Control Study

Quek

Kam

et al. 2017

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Beta-Blocker Use and Risk of Symptomatic Bradyarrhythmias: A Hospital-Based Case-Control Study

Quek

Kam

et al. 2017

International Journal of Cardiology

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“…This is in keeping with other international studies. 10 This suggested that bradycardia was due to underlying conductive system disease in majority of patients rather than rate slowing drugs. 10 Older age of our patient also supported it because these patients are more likely to have underlined conduction system disease which was subclinical.…”

Section: Discussionmentioning

confidence: 99%

“…10 This suggested that bradycardia was due to underlying conductive system disease in majority of patients rather than rate slowing drugs. 10 Older age of our patient also supported it because these patients are more likely to have underlined conduction system disease which was subclinical. 14 In majority of cases in which bradycardia persisted, there was third degree heart block, which in almost all the cases was of infra-nodal variety.…”

Section: Discussionmentioning

confidence: 99%

“…10 In patients of AV block, drugs as sole causative agent was uncommon and observed in only 8%. The majority continued to suffer from AV block even after discontinuation of medications like β-blocker or calcium channel blockers who presented with 2 nd or 3 rd degree AV block.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 and drug-associated bradycardia. 10 Drugs which cause bradycardia include β blockers, rate limiting calcium channel blockers and digitalis 11 with combined drug therapy increases the risk of significant bradycardia.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Persistent Bradycardia; The Outcome in Patients With Bradycardia After Discontinuation of Rate Slowing Drugs in Terms of Frequency

Abbas

Fatima

Hameed

et al. 2017

TPMJ

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ABSTRACT… Objectives: To determine the outcome in patients with bradycardia after discontinuation of rate slowing drugs in terms of frequency of persistent bradycardia. Study Design: Descriptive study. Setting: Faisalabad Institute of Cardiology, Cardiology Department. Period: 2013-2014. Materials and Methods: Pulse and ECG were used to identify the patients and after obtaining informed consent, total 95 patients of bradycardia were included from emergency. Patients with persistent bradycardia were noted after 5 days of discontinuation of culprit drug. Results: Among total 95 patients, 46(48.4%) were male and 49(51.6%) were female. Patients with rate limiting drugs include β blockers 79(75.8%), CCBs 19(20%) and digoxin 4(4.2%). Patients presented to hospital have sinus bradycardia 3(3.2%), 2 nd degree AV block 19(20%) and 3 rd degree AV block 73(76.8%). After 5 days of discontinuation of culprit drug, bradycardia persisted in 32(69.6%) male, 37(75.5%) female patients with sinus bradycardia persisted in 1(33.3%), 2 nd degree AV block in 7(36.8%) and 3 rd degree AV block in 61(83.6%). Conclusion: In majority of patient on rate slowing drug, bradycardia persisted after discontinuation of these drugs. Bradycardia was not truly drug induced, but it was due to underlying conducting system disease which was unmasked by rate slowing drugs. Key words:Bradycardia, Persistent Bradycardia, Rate Slowing Drugs, β-Blocker, Digoxin, Non Dihydropyridine Calcium Channel Blocker, Underlying Conducting System Disease. Article Citation: Abbas S, Fatima S, Hameed N, Qasim M. Persistent bradycardia; The outcome in patients with bradycardia after discontinuation of rate slowing drugs in terms of frequency.

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Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug

Abstract: Atrioventricular block is commonly "related to drugs" but is rarely "caused by drugs."

Cited by 117 publications

References 7 publications

Beta-Blocker Use and Risk of Symptomatic Bradyarrhythmias: A Hospital-Based Case-Control Study

Beta-Blocker Use and Risk of Symptomatic Bradyarrhythmias: A Hospital-Based Case-Control Study

Persistent Bradycardia; The Outcome in Patients With Bradycardia After Discontinuation of Rate Slowing Drugs in Terms of Frequency

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