A hypeensive patient was on metoprolol treatment. Verapamil was added to the therapy of this patient. This can result in
(A) Atrial fibrillation (B) Bradycardia with AV block (C) Torsades de pointes (D) Tachycardia
(B) Metoprolol (Cardioselective beta blocker) decrease hea rate and AV conduction. Verapamil and Diltiazem: CCB (calcium channel blocker): These also inhibits SA Node and AV Node, hence depress the hea. So, when verapamil (or Diltiazem) is combined with metoprolol, they both depress hea and lead to bradycardia with AV block. Other CCBs include dihydropyridines (like amlodipine etc). These dipines can be used with Metoprolol as they cause reflex tachycardia.