Diltiazem-induced Transient Complete Atrioventricular Block in an Elderly Patient with Acute on Chronic Renal Failure

Diltiazem is a calcium channel blocker commonly used in the treatment of various cardiovascular disorders such as hypertension, angina and supraventricular tachycardias. Metabolism occurs mainly in the liver, but a small percentage of unchanged drug and metabolites are excreted in the urine. Toxicity from this medication usually presents in the form of dysrrhytmias and heart block. Hence, we present a case of complete atrioventricular AV block in a patient receiving sustained- release diltiazem on a chronic basis. Risk factors such as advanced age and impaired renal function are dis-cussed.