Calcium Channel Blockers and Bradycardia

Mechanism of Action and Effects

• Non-dihydropyridine calcium channel blockers have more pronounced effects on cardiac tissue, including the sinoatrial and atrioventricular nodes, resulting in negative chronotropy at normal doses 1
• The European Society of Cardiology distinguishes that non-dihydropyridines decrease the sinus node discharge rate and slow atrioventricular nodal conduction, whereas dihydropyridines like amlodipine do not 3

Clinical Guidelines and Recommendations

• Guidelines specifically note that dihydropyridines cause peripheral oedema, reflex tachycardia, while non-dihydropyridines cause bradycardia, AVB, according to the European Heart Journal 2