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Related Concept Videos

Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

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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...
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Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

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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...
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Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

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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,...
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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

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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...
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Drugs Acting on Autonomic Ganglia: Stimulants01:23

Drugs Acting on Autonomic Ganglia: Stimulants

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Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
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Drugs Acting on Autonomic Ganglia: Blockers01:28

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Ganglionic blockers inhibit autonomic activity by blocking nicotinic receptors in the autonomic ganglia, suppressing impulse transmission. These blockers lack selectivity between sympathetic and parasympathetic ganglia and are ineffective as neuromuscular junction antagonists. They can be categorized into two groups:
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Atrio-Ventricular Nodal Block Associated with Methamphetamine Use.

Nicholas L Vitagliano1, Tyler Ky1, John M Kennedy2

  • 1Department of Internal Medicine, College Medical Center, Long Beach, CA, USA.

The American Journal of Case Reports
|November 10, 2025
PubMed
Summary
This summary is machine-generated.

Methamphetamine use can rarely cause severe heart rhythm problems like high-grade atrio-ventricular (AV) block, leading to heart failure. Early recognition of these cardiac complications is crucial for timely intervention and management.

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Area of Science:

  • Cardiology
  • Toxicology
  • Electrophysiology

Background:

  • Methamphetamine use is rising globally, particularly among young adults.
  • Cardiovascular complications are a known risk, typically involving QT prolongation and tachyarrhythmias.
  • High-grade atrio-ventricular (AV) blocks and bradyarrhythmias are rare presentations of methamphetamine toxicity.

Purpose of the Study:

  • To report a rare case of high-grade AV block secondary to methamphetamine toxicity.
  • To highlight the unusual presentation of bradyarrhythmia in methamphetamine users.
  • To emphasize the importance of recognizing and managing cardiac complications associated with methamphetamine use.

Main Methods:

  • Case report of a 40-year-old male with methamphetamine dependence.
  • Continuous telemetry monitoring revealing 2:1 and 3:1 AV block.
  • Electrocardiogram (ECG) showing PR prolongation and transient heart block.
  • Echocardiography assessing left ventricular ejection fraction (LVEF).
  • Cardiac Magnetic Resonance Imaging (MRI) for biventricular function and thrombus detection.
  • Nuclear imaging to rule out amyloidosis.

Main Results:

  • Patient presented with symptoms of heart failure (dyspnea, edema) and chest pain.
  • Telemetry and ECG confirmed transient high-grade AV block (2:1 and 3:1) associated with sinus tachycardia and desaturation.
  • Echocardiography revealed severe global hypokinesis and LVEF of 20%.
  • Cardiac MRI showed severe biventricular dilation and dysfunction.
  • Patient received an implantable cardioverter-defibrillator (ICD) for primary prevention.

Conclusions:

  • Methamphetamine toxicity can unmask or cause distal conduction system disease, leading to severe bradyarrhythmias.
  • This case underscores the potential for methamphetamine to induce significant cardiac dysfunction and conduction abnormalities.
  • Prompt recognition and management, including permanent pacing if necessary, are critical for patients presenting with these complications.