Nifedipine induced bradycardia in a patient with autonomic neuropathy

1989 Japanese Heart Journal  
An 80 year old diabetic male with evidence of peripheral and autonomic neuropathy was admitted with chest pain. He was found to have atrial flutter at a ventricular rate of 70/min which slowed down to 30-40/min when nifedipine (60mg) in 3 divided doses, during which he was paced at a rate of 70/min. This is inconsistent with the well-established finding that nifedipine induces tachycardia in normally innervated hearts. However, in hearts deprived of compensatory sympathetic drive, it may lead to bradycardia.
doi:10.1536/ihj.30.679 fatcat:qy7y5aeuizd2fdbqbgegzffyhi