Prognosis and Natural History of Drug-Related Bradycardia.
10.4070/kcj.2009.39.9.367
- Author:
Jang Hoon LEE
1
;
Hyeon Min RYU
;
Myung Hwan BAE
;
Yong Seop KWON
;
Ju Hwan LEE
;
Yongwhi PARK
;
Jung Ho HEO
;
Young Soo LEE
;
Dong Heon YANG
;
Hun Sik PARK
;
Yongkeun CHO
;
Shung Chull CHAE
;
Yoon Nyun KIM
;
Jae Eun JUN
;
Wee Hyun PARK
Author Information
1. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. choyk@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Bradycardia;
Atrioventricular block;
Arrhythmia;
Drugs
- MeSH:
Arrhythmias, Cardiac;
Atrioventricular Block;
Bradycardia;
Calcium Channel Blockers;
Dichlororibofuranosylbenzimidazole;
Electrocardiography;
Follow-Up Studies;
Humans;
Natural History;
Prognosis;
Retrospective Studies;
United Nations
- From:Korean Circulation Journal
2009;39(9):367-371
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The prognosis and natural history of bradycardia related to drugs such as beta-blockers and non-dihydropyridine calcium channel blockers are not well known. SUBJECTS AND METHODS: 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. RESULTS: The initial electrocardiogram (ECG) showed sinus bradycardia (heart rate < or =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. CONCLUSION: Beta-blockers were the most common drugs associated with DRB. However, in one quarter of the cases the DRB was not associated with drugs; in these patients permanent pacemaker implantation should be considered.
