A case of atenolol-induced sinus node dysfunction presenting as escape-capture bigeminy

Medications that are routinely used in clinical practice to treat hypertension such as beta blockers or non-dihydropyridine calcium channel blockers can depress sinus node function, resulting in symptoms and electrocardiographic changes consistent with sinus node dysfunction. In some patients, medications are potentially a reversible cause of apparent sinus node dysfunction. We report a patient who was taking atenolol for hypertension presented with recurrent near syncopal spells due to atenolol-induced sinus node dysfunction manifested in the form of an interesting and rare arrhythmia known as Escape-capture bigeminy.