Clonidine therapy can induce severe, reversible sinus node dysfunction, including prolonged sinus arrest, in addition to known AV node abnormalities.
Clonidine may induce reversible sinus arrest; single case leaves open incidence and causality in broader populations.
A 65-year-old male with diabetes, hypertension, and mild renal failure developed dizziness and syncope one week after starting clonidine 0.45 mg/day. A continuous ECG recording revealed sinus bradycardia, nodal rhythm, and multiple episodes of sinus arrest lasting up to 4.5 seconds. Upon discontinuation of clonidine, serial continuous ECG recordings revealed gradual decrease in the number and duration of the sinus arrest episodes, until their complete disappearance shortly after the third day off clonidine. This report shows that clonidine may cause a concentration-dependent sinus node dysfunction in addition to the atrioventricular (AV) node abnormalities previously ascribed to it.
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Schwartz et al. (1988) studied this question.
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