Supplements: Be sure to tell your doctor about any herbal remedies you may be using. Ephedra, the herbal supplement once promoted as a diet aid and energy booster, increases the risk of arrhythmia. In 2004 the FDA pulled it from the shelves for that very reason. Other herbal supplements may contribute to arrhythmias.
Caffeine, nicotine, and other drugs: Stimulants, both legal and illegal, can contribute to the development of heart arrhythmias. Caffeine and nicotine may in some cases cause premature heartbeats, which, over time, may develop into more serious arrhythmias. Cocaine and amphetamines also accelerate the heart rate, in some cases leading to serious ventricular fibrillation and sudden death. In addition to alcohol's role in heart disease, a single episode of heavy consumption can trigger arrhythmias like atrial fibrillation.
Medications: Many medications have as a side effect the potential to cause arrhythmias. Over-the-counter cough and cold medicines may speed up the heart. And approximately 50 FDA-approved medications have the potential to prolong the QT interval--the measure of time it takes for the electrical system in the ventricles to recharge after each heartbeat--and thus cause the acquired form of long QT syndrome (LQTS), in which the heart's mechanical or pumping function is normal but its recharging system is slow or inefficient. Those medications include certain antibiotics, antidepressants, antifungals, antihistamines, psychotropic medications, oral hypoglycemics (medications for diabetes), and even drugs used to treat heart disease like lipid-lowing medications and diuretics. It's important that people with inherited LQTS, then, always ask physicians and pharmacists if a prescribed medication has the potential to aggravate the condition.
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