. 2025 Mar 30;27(8):euaf076. doi: 10.1093/europace/euaf076

Table 11.

Effects of AADs on sinus node function

Modified VW class	Drug	Potential for SN depression
0	Ivabradine	Moderate
Ia	Quinidine	Mild^a
	Procainamide	Mild
	Disopyramide	Mild^a
Ib	Mexiletine/lidocaine	∼None
Ic	Flecainide	Mild to moderate^b
Ic	Propafenone	Mild to moderate^b
Id	Ranolazine	∼None
IIa	β-Blockers	Potent
IIb	Isoprenaline	∼None (reverse depression)
IIc	Atropine	∼None (reverse depression)
IId	Digitalis	Variable (depends upon autonomic balance; mild direct effect)
IIe	Adenosine	Potent
III	Amiodarone	Potent
	Dronedarone	Mild
	Dofetilide	∼None
	Ibutilide	∼None
	Sotalol	Potent
	Vernakalant	Mild to moderate
IV	Verapamil	Mild^a
IV	Diltiazem	Mild^a

Abbreviations: AAD, anti-arrhythmic drug; SN, sinus node.

^aAssociated mild vasodilation partially offsets SN depression.

^bModerate in patients with SN dysfunction.