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Author: Admin | 2025-04-28
Drug-Induced Arrhythmias: List of Drugs that May Cause ArrhythmiaThere are many commonly used medications that can cause a variety of abnormal heart rhythms (arrhythmias). These drug-induced arrhythmias are often the result of medication-induced changes in electrical conduction within the heart which can produce heart rhythms that are too fast (tachyarrhythmias) or too slow (bradyarrhythmias). Common drugs that may cause arrhythmias include certain antiarrhythmics, antibiotics, antidepressants, anticancer treatments, neurologic drugs and stimulants. Atrial fibrillation is an abnormal heart rhythm that is frequently treated with antiarrhythmics. Sometimes atrial fibrillation medications that are used to restore a normal heart rhythm can have the unintended effect of causing arrhythmia and are therefore monitored closely. What medications can produce arrhythmias?Electrical signals which travel throughout the heart cause the muscle cells to contract and produce a heart beat. Medications that change the way electrical signals travel or which change the way the heart muscle cells respond to electrical signals can produce arrhythmias. The medications that are the most likely to cause arrhythmias are the ones that are designed to treat abnormal heart rhythm issues (antiarrhythmic medications). Tachyarrhythmias Common drug-induced tachyarrhythmias include: Atrial fibrillation (AFib) and atrial flutterAtrial tachycardia and supraventricular tachycardia Ventricular tachycardia. Fast abnormal heart rhythm that originates in the lower heart chambers (ventricles). It causes the heart to pump less effectively and can lead to serious complications, like ventricular fibrillation. Torsades de pointes. Medications that slow electrical conduction can cause QT prolongation which can lead to a serious tachyarrhythmia called torsades de pointes. Drugs that can cause atrial fibrillation and atrial flutter are reviewed later in this article. Some frequently prescribed medications that have been associated with ventricular tachycardia or QT prolongation include:Ventricular Tachycardia. Ginkgo biloba, cocaine, and methamphetamine have been associated with ventricular tachycardia. In addition, certain antiarrhythmics, antidepressants, anticancer drugs, and some psychiatric drugs have the potential to contribute to ventricular tachycardia. Torsades de Pointes. It is well-known that some antiarrhythmics, particularly dofetilide and sotalol, can lead to QT prolongation and Torsades de pointes. Therefore, patients starting these medications are monitored closely and are often admitted to the hospital for a few days so their heart can be monitored for QT prolongation. There are to other, non-cardiac, medications that can cause QT prolongation including:Antibiotics. Some antibiotics that are commonly used for pneumonia, bronchitis, and urinary tract infections can cause QT prolongation. These include: Azithromycin (Zithromax, Z Pak), clarithromycin, erythromycin, ciprofloxacin (Cipro), and levofloxacin (levaquin). Antimalarials. Chloroquine and hydroxychloroquine can cause QT prolongation. Antifungal. FluconazoleCocaineAt one stage during the COVID-19 pandemic, QT prolongation became an issue when caring for hospitalized COVID-19 patients because they were often given multiple medications which had an additive effect in prolonging the QT interval. BradyarrhythmiasCommon drug-induced bradyarrhythmias include:
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