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Histamine 2 receptor blocker-ranitidine and sinus node dysfunction

W H Hu1, K Y Wang, D S Hwang

  • 1Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|July 1, 1997
PubMed
Summary
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Ranitidine can prolong sinus cycle length in patients with sinus node dysfunction, especially after autonomic blockade. Careful administration with continuous monitoring is advised for patients with autonomic denervation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Histamine 2 (H2) receptors are present in the sinus node.
  • H2 receptor blockers may affect sinus node function, but data on ranitidine is limited.
  • Bradycardia has been anecdotally linked to ranitidine use.

Purpose of the Study:

  • To evaluate the electrophysiological effects of ranitidine on sinus node function.
  • To determine the safety of ranitidine in patients with sinus node dysfunction.

Main Methods:

  • 39 patients with sinus node dysfunction received 150 mg intravenous ranitidine.
  • Electrophysiological parameters (SCL, SNRT, CSNRT, SACT, AH, HV) and blood pressure were analyzed.
  • Tests were conducted in basal state and after autonomic blockade (propranolol and atropine).

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Main Results:

  • Ranitidine did not significantly alter electrophysiological parameters in the basal state.
  • After autonomic blockade, ranitidine significantly prolonged sinus cycle length (SCL).
  • Ranitidine also significantly decreased systolic and diastolic blood pressure after autonomic blockade.

Conclusions:

  • Administer 150 mg ranitidine slowly over at least 5 minutes for patients with sinus node dysfunction.
  • Continuous monitoring of blood pressure and heart rate is essential.
  • Particular caution is needed in patients with autonomic denervation.