Key result
AV node inhibitors, polypharmacy, prolonged PQ intervals, and organ disease drive drug-induced AV block risk.
Why the study?
Atrioventricular blockages are a serious heart rhythm disorder that can be induced by medications, prompting a need to systematize literature data to increase awareness among practitioners and patients.
This review highlights the mechanisms, risk factors, and management strategies for drug-induced atrioventricular blockages to improve clinical awareness and prevention.
Atrio-ventricular (AV) blockages are a serious violation of the heart rhythm. One of the reasons for the development of this pathology may be taking medications. This effect has a significant number of drugs used for the treatment of diseases of the cardiovascular system, central nervous system, general and local anesthetics, antineoplastic drugs, and many others. The main mechanism for the development of drug-induced AV blockades is the inhibition of AV node conduction. The most common risk factors for the development of drug-induced AV blockades are taking two and more drugs that have an inhibitory effect on AV conduction, the initial duration of the PQ interval more than 0.2 second, initial dysfunction of the AV node, increased plasma concentration of a potential inducer drug due to the presence of kidney and/or liver disease, drugdrug interactions, and specific risk factors for individual drugs. Special attention in solving this problem should be paid to both stopping the developed AV conduction disorder – medication or using an electric cardiostimulator, and its prevention. This article systematizes the literature data on drug-induced AV blockades in order to increase the awareness of practitioners and patients about their prevalence, risk factors, approaches to diagnosis, treatment and prevention.
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Kulikova et al. (2020) conducted a review in Drug-induced atrioventricular blockages. Medications (cardiovascular, CNS, anesthetics, antineoplastic drugs) was evaluated. Drug-induced atrioventricular blockades are commonly caused by medications inhibiting AV node conduction, with risk factors including polypharmacy, prolonged PQ interval, and underlying organ disease.
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