SEVERE BRADYARRHYTHMIA AS A LIFE-THREATEN ING ADVERSE EFFECT OF VERAPAMIL SR IN 2 HEMODIALYZED PATIENTS

Two patients with end-stage renal disease on maintenance hemodialysis treated with verapamil SR at the recommended doses for hypertension su ffered from a severe bradycardia as an adverse event (third-degree AV block and nodal bradycardia). Patients present with associated hyperka lemia and hypotension, requiring inotropic and hemodynamic support and one oi them also required a temporary pacemaker. Both patients were t reated with a haemodialysis session to correct hyperkalemia. After hyp erkalemia was corrected by dialysis, cardiac rhythm disturbances retur ned to normal. Nine other similar case oi severe bradyarrhythmia du ri ng verapamil treatment in chronic renal failure patients have been des cribed so far. We recommend caution in treating chronic renal failure patients with this drug.