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Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...

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Updated: Jun 12, 2026

Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice
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Published on: June 29, 2022

Benzodiazepine-associated atrioventricular block.

Anna M Arroyo Plasencia1, Lynn M Ballentine, James B Mowry

  • 1Department of Medicine Division of Hospital Medicine, Washington University School of Medicine, St. Louis, MO, USA. aarroyo@neoucom.edu

American Journal of Therapeutics
|June 11, 2010
PubMed
Summary
This summary is machine-generated.

Benzodiazepine misuse can cause rare heart rhythm problems like atrioventricular block. These cases highlight a potential complication of benzodiazepine exposure, even in young patients.

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Published on: December 11, 2017

Area of Science:

  • Cardiology
  • Clinical Toxicology
  • Pharmacology

Background:

  • Dysrhythmias are common in overdose scenarios but infrequently linked to benzodiazepine exposure.
  • Benzodiazepines are widely prescribed, making understanding their potential adverse effects crucial.

Observation:

  • Two cases of transient atrioventricular block (AV block) following benzodiazepine misuse are presented.
  • Case 1: A child experienced first-degree and subsequently second-degree AV block (Mobitz Type 1) after clonazepam ingestion, resolving after flumazenil administration.
  • Case 2: An adult developed second-degree AV block (Mobitz Type I) after ingesting alprazolam with other substances, which resolved over time.

Findings:

  • Both patients exhibited transient atrioventricular block (first- and second-degree) after benzodiazepine exposure.
  • Electrocardiogram (EKG) abnormalities, including Mobitz Type 1 AV block, were observed and subsequently resolved.
  • Elevated serum clonazepam levels were noted in the pediatric case, indicating significant exposure.

Implications:

  • These cases suggest a rare but serious complication of benzodiazepine exposure, specifically transient atrioventricular block.
  • Benzodiazepines' known effect on L-type calcium channels may underlie the observed cardiac dysrhythmias.
  • Clinicians should be aware of this potential adverse effect when managing benzodiazepine exposures.