Bradycardia / syncope (rivastigmine, sick sinus)

HIGH-YIELD Appears 7×

Teaching point

Bradycardia in a patient on rivastigmine (cholinesterase inhibitor) +/- beta-blocker -> REMOVE the offending drug first (rivastigmine patch); atropine/pacing if unstable. Recurrent exertional syncope + bradycardia -> arrhythmia -> pacemaker (sick sinus / heart block).

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