Sinoatrial Node

Amiodarone decreases the slope of phase 4 depolarization. The rate of spontaneous discharge of the sino-atrial node is increased by amiodarone as well as by its metabolite, desethylamiodarone. The depressant action of amiodarone on sinoatrial pacemaker function is, in addition to p-receptor blockade, related to an inhibition of the slow inward current carried by the calcium ion.

Amiodarone prolongs the action potential in atrial muscle and increases the absolute and effective refractory periods.

Amiodarone, like its major metabolite desethyl-amiodarone, increases A-V nodal conduction time and refractory period.

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