THE OUTCOME IN PATIENTS WITH BRADYCARDIA AFTER DISCONTINUATION OF RATE SLOWING DRUGS IN TERMS OF FREQUENCY
Keywords:Bradycardia,, Persistent Bradycardia,, Rate Slowing Drugs,, β-Blocker,, Digoxin,, Non Dihydropyridine Calcium Channel Blocker,, Underlying Conducting System Disease.
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%), 2nd degree
AV block 19(20%) and 3rd 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%), 2nd degree AV block in 7(36.8%) and 3rd 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.