Disopyramide directly depresses myocardial contractility. The negative inotropic effect may be detrimental in patients with compromised cardiac function. Some patients develop overt congestive heart failure. At usual therapeutic doses, depression of myocardial function is not a problem in most patients with normal ventricular function.
Despite the decrease in cardiac output produced by disopyramide, blood pressure is well maintained by a reflex increase in vascular resistance. Catecholamine administration can reverse the myocardial depression.
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