Related Experiment Video
Updated: Aug 14, 2025
14:09
Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
20.9K
Paxlovid-Induced Symptomatic Bradycardia and Syncope
Venu M Ganipisetti1, Pratyusha Bollimunta1, Sriram Maringanti2
1Hospital Medicine, Presbyterian Hospital, Albuquerque, USA.
Cureus
|January 19, 2023
Summary
Paxlovid, used for COVID-19, may be linked to bradycardia. Discontinuation and prompt medical care reversed symptoms in a case study, suggesting careful monitoring.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Paxlovid (nirmatrelvir/ritonavir) is a key antiviral treatment for COVID-19, known for reducing severe disease progression.
- Cardiac adverse events have not been previously associated with Paxlovid use.
Observation:
- A 71-year-old patient experienced symptomatic bradycardia, syncope, and sinus pause after initiating Paxlovid therapy.
- The patient's symptoms resolved promptly after discontinuing Paxlovid and receiving intravenous atropine.
Findings:
- This case report suggests a potential association between Paxlovid and the development of bradycardia.
- The observed cardiac events were reversible upon medication cessation.
Implications:
- Clinicians should consider Paxlovid as a potential cause of bradycardia in patients presenting with relevant symptoms.
- Discontinuation of Paxlovid and close cardiac monitoring for approximately 40 hours (five half-lives) is recommended upon evidence of bradycardia.
Related Concept Videos
01:14Decreased pulse rate
584
Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
584
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
17
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...
17
01:17Measurement of Blood Pressure
1.2K
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
1.2K
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
814
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...
814
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
62
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
62
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
921
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
921