{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:57:59Z","timestamp":1769155079000,"version":"3.49.0"},"reference-count":46,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,20]],"date-time":"2022-02-20T00:00:00Z","timestamp":1645315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Drug-related bradyarrhythmia is a well-documented major adverse event among beta-blocker users and a potential cause for hospitalization or additional interventions. Whether beta-blocker use is associated with specific bradyarrhythmia presentations, and how this relates to other predisposing factors, is not well known. We aim to evaluate the association between beta-blocker use and the type of atrioventricular (AV) conduction disorder in patients with symptomatic bradycardia. Materials and Methods: We conducted a retrospective cohort study on 596 patients with a primary diagnosis of symptomatic bradyarrhythmia admitted to a single tertiary referral center. Of the cases analyzed, 253 patients were on beta-blocker treatment at presentation and 343 had no bradycardic treatment. We analyzed demographics, clinical and paraclinical parameters in relation to the identified AV conduction disorder. A multivariate regression analysis was performed to explore factors associated with beta-blocker use. Results: Of the 596 patients (mean age 73.9 \u00b1 8.8 years, 49.2% male), 261 (43.8%) had a third-degree AV block, 92 (15.4%) had a second-degree AV block, 128 (21.5%) had slow atrial fibrillation, 93 (15.6%) had sick sinus syndrome and 21 (3.5%) had sinus bradycardia\/sinus pauses. Beta-blocker use was associated with the female gender (p &lt; 0.001), emergency admission (p &lt; 0.001), dilated cardiomyopathy (p = 0.003), the lower left ventricular ejection fraction (p = 0.02), mitral stenosis (p = 0.009), chronic kidney disease (p = 0.02), higher potassium levels (p = 0.04) and QRS duration &gt; 120 ms (p = 0.02). Slow atrial fibrillation (OR = 4.2, p &lt; 0.001), sick sinus syndrome (OR = 2.8, p = 0.001) and sinus bradycardia\/pauses (OR = 32.9, p &lt; 0.001) were more likely to be associated with beta-blocker use compared to the most common presentation (third-degree AV block), after adjusting for other patient characteristics. Conclusions: Beta-blocker use is more likely to be associated with slow atrial fibrillation, sick sinus syndrome and sinus bradycardia\/pauses, compared to a second- or third-degree AV block, after adjusting for other patient factors such as gender, admission type, ECG, comorbidities, cardiac function and lab testing.<\/jats:p>","DOI":"10.3390\/medicina58020320","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T08:22:19Z","timestamp":1645431739000},"page":"320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Beta-Blocker-Related Atrioventricular Conduction Disorders\u2014A Single Tertiary Referral Center Experience"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2334-9953","authenticated-orcid":false,"given":"Drago\u0219 Traian Marius","family":"Marcu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-3320","authenticated-orcid":false,"given":"Cristina Andreea","family":"Adam","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Diseases \u201cProf. Dr. George I. M. Georgescu\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan-Mihai","family":"Doroban\u021bu","sequence":"additional","affiliation":[{"name":"Children\u2019s Health and Exercise Research Centre (CHERC), University of Exeter, Exeter EX1 2LU, UK"},{"name":"Congenital Heart Unit, Bristol Royal Hospital for Children and Heart Institute, Bristol BS2 8BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delia Lidia","family":"\u0218alaru","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"},{"name":"Institute of Cardiovascular Diseases \u201cProf. Dr. George I. M. Georgescu\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radu Andy","family":"Sasc\u0103u","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"},{"name":"Institute of Cardiovascular Diseases \u201cProf. Dr. George I. M. Georgescu\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mircea Ovanez","family":"Balasanian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"},{"name":"Institute of Cardiovascular Diseases \u201cProf. Dr. George I. M. Georgescu\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liviu","family":"Macovei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"},{"name":"Institute of Cardiovascular Diseases \u201cProf. Dr. George I. M. Georgescu\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103t\u0103lina","family":"Arsenescu-Georgescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-4561","authenticated-orcid":false,"given":"Cristian","family":"St\u0103tescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"},{"name":"Institute of Cardiovascular Diseases \u201cProf. Dr. George I. M. Georgescu\u201d Ia\u0219i, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jacc.2004.03.057","article-title":"Drug-Induced Atrioventricular Block: Prognosis after Discontinuation of the Culprit Drug","volume":"44","author":"Zeltser","year":"2004","journal-title":"J. Am. Coll. 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