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Drug-Induced Arrhythmia: 5 Medications That May Affect Your Heart Rate

by — Last updated: 2021-04-14 in Cardiovascular Disorders and Diseases

Arrhythmia encompasses a number of dangerous heart conditions, and although healthy-unhealthy risk factors are generally well known, medicines that can cause arrhythmia and affect your heart rate are not.

Arrhythmia is a surprisingly common type of heart condition that can have major effects on a person’s health. It is estimated that more than nine percent of people over 65 have at least one type of arrhythmia, and the risk only increases with age.

Despite this, many people are unaware of the dangers of arrhythmias, which simply describe conditions that cause an abnormal heart rate. Although some arrhythmias are harmless or even natural, a number of them can cause noticeable symptoms and lead to heart failure and have other severe consequences for a person's health and lifespan.

Fortunately, increasing numbers of people follow common health tips such as avoiding excess sugar and fats, getting adequate exercise, and limiting their alcohol intake. However, certain medications represent a little-mentioned risk factor for arrhythmias. What do you need to know about the medications that can have a negative impact on your heart rate?

What medicines can lead to arrhythmias?

It would be impossible to list every brand and type of medicine that can lead to arrhythmia in this article, because of the multitude of different medications on the market that can, in fact, have this consequence. Let's take a look at broad classes of medicines that can lead to certain arrhythmias and affect your heart rate, however. 

Antidepressants 

Certain antidepressants have been associated with some types of arrhythmia. One Harvard study concluded that Elavil, Lexapro, and Celexa — all very popular antidepressant medications — can slightly alter some of the electrical signals that control the heart. The heart is controlled by electrical signals the produce the “beats”, however, these antidepressants can cause a small delay in these electrical signals. This delay can lead to a knock-on effect as the heart becomes more and more "backed up". 

This delay is a risk factor for an arrhythmia that causes sudden death. Although most people who suffer from this type of delay due to the fact that they are taking antidepressants never develop an arrhythmia, it’s important to talk to your doctor about the risks if you have been prescribed any of these medicines. Also, people with a history of other arrhythmias should entirely avoid these brands, instead opting for an antidepressant like Prozac, Zoloft, or Wellbutrin, which were not found to be associated with these symptoms.

Calcium blockers

Calcium blockers are used to treat several heart conditions, such as certain arrhythmias and hypertension (high blood pressure) as well as types of hemorrhage and migraines. Calcium blockers work by preventing calcium from reaching parts of the heart and blood vessels, which relaxes the blood vessels and causes them to widen, resulting in lower blood pressure.

However, the relaxation caused by certain drugs, such as verapamil and diltiazem, leads to more than just widened blood vessels. It can also cause the heart to slow down too much — which can result in bradycardia (in plain English, a dangerouslu slow heart rate). This presents a risk for certain arrhythmias. 

Beta blockers

Beta blockers are a class of medication usually used to treat high blood pressure in addition to several other heart conditions. To put it simply, beta blockers bind themselves to so-called “beta receptors” and can cause the heart to slow down in addition to relaxing muscles to lower heart rate and blood pressure.

However, an improper dose of beta blockers can lead to bradycardia (a slow heart rate) in addition to a blood pressure that is too low (hypotension). An overdose of beta blockers can also cause fatigue and dizziness, as well as certain kinds of beta blockers, such as sotalol, exacerbating some types of preexisting arrhythmias. It is important to go over your medical history with your doctor to discover how much you should be taking and whether you should be taking beta blockers at all.

Adrenergic drugs

Adrenergic drugs are a broad category of medication that block receptors called adrenergic receptors. They can be used to treat a great number of different ailments, such as ADHD, hypertension, heart failure, lung diseases, and cardiac arrest. Using these medications blocks certain substances such as adrenaline from taking effect in the body.

Because there are several different types of adrenergic medications, it is best to get clear instructions from your doctor as to which types and brands you should be taking. Improper use, overdosing, or side effects of certain drugs within this category, such as phenylephrine or clonidine, can lead to a multitude of complications such as hypertension, bradycardia, hypotension, or tachycardia (a fast heart rate). If you have an arrhythmia or have a history of arrhythmias, make sure to tell your doctor as some types of adrenergic drugs can present risks to those people who have arrhythmias. 

Cardiac glycoside

Cardiac glycosides are used to treat heart failure as well as types of arrhythmia. This generally refers to digitalis and offshoots such as digoxin and digitoxin. This drug causes chemical reactions that increase the force of the heart. It is often administered as tablets and rarely has worrying side effects.

However, taking more than the recommended amount, either accidentally or purposefully, can induce severe side effects that patients should be aware of. These side effects can include other types of arrhythmia such as heart block and bradycardia, as well as seizures, blurred vision, nausea, and vomiting. In addition, these drugs can build up in the body over time. Make sure to get a suitable dose for you if prescribed by a doctor, and monitor your condition so that the build-up does not cause adverse effects.

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