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Diltiazem is a potent vasodilator, increasing blood flow and variably decreasing the heart rate via strong depression of A-V node conduction. It binds to the alpha-1 subunit of L-type calcium channels in a fashion somewhat similar to verapamil , another nondihydropyridine (non-DHP) calcium channel blocker. [ 28 ]
Most people who have taken too much of a calcium channel blocker, especially diltiazem, get slow heart rate and low blood pressure (vasodilatory shock). [1] This can progress to the heart stopping altogether. [2] CCBs of the dihydropyridine group, as well as flunarizine, predominantly cause reflex tachycardia as a reaction to the low blood ...
The negative chronotropic effects of CCBs make them a commonly used class of agents in individuals with atrial fibrillation or flutter in whom control of the heart rate is generally a goal. Negative chronotropy can be beneficial when treating a variety of disease processes because lower heart rates represent lower cardiac oxygen requirements.
However, oftentimes lower heart rates can be totally normal, and a well-trained athlete can have a normal heart rate in the 50s or as low as 40 without any cause for concern, he notes.
A lower resting heart rate or slower heartbeat will fill the ventricles/heart better and allow for more of a forceful contraction of blood out to the rest of the body, says Dr. Weinberg.
“The more exercise and regular cardiovascular exertion that you have, the lower your resting heart rate will be,” Ebinger tells Fortune. “That’s a reflection of a healthy cardiovascular ...
They thus reduce the contractility of the heart, so may be inappropriate in heart failure. However, in contrast to beta blockers, they allow the body to retain adrenergic control of heart rate and contractility. [citation needed] Class IV agents include verapamil and diltiazem.
While negative inotropism may precipitate or exacerbate heart failure in the short term, certain beta blockers (e.g. carvedilol, bisoprolol and metoprolol) have been believed to reduce long-term morbidity and mortality in congestive heart failure. [13] Examples of negative inotropic agents include: Beta blockers [14]