Atrial Fibrillation: Medications That Might Increase Risk

Atrial fibrillation (AFib) is an irregular heartbeat that can increase the risk of stroke and heart complications. According to the American Heart Association (AHA) and the Cleveland Clinic, AFib may be influenced by lifestyle, medical conditions, and in some cases, medications. While these medications may be necessary for treating other conditions, patients with AFib—or those at risk—should discuss options with their healthcare provider before making changes.

You May Want to Avoid These Medications

1. Decongestants (Pseudoephedrine, Phenylephrine)

Found in over-the-counter cold and flu medicines.
Stimulate the cardiovascular system, raising heart rate and blood pressure.
May trigger arrhythmias in sensitive individuals.

2. Stimulants (ADHD Medications, Weight Loss Drugs, Energy Pills)

Increase adrenaline and heart stimulation.
May provoke palpitations and AFib, especially at higher doses.

3. Asthma and COPD Medications (Theophylline, High-dose Beta-agonists)

Relax airway muscles but may also overstimulate the heart.
Patients with both lung disease and AFib require careful management.

4. Chemotherapy Agents

Some cancer treatments (e.g., anthracyclines) affect the heart’s electrical system.
Require close monitoring for cardiac side effects.

5. Thyroid Hormone (Levothyroxine Overdose)

Excessive thyroid hormone speeds up metabolism and heart rate.
Overmedication may cause or worsen AFib.

They May Cause AFib: Why It Happens

Increased Sympathetic Activity: Drugs that stimulate the nervous system increase heart rate and blood pressure.
Electrolyte Disturbances: Some drugs alter potassium or magnesium levels—vital for heart rhythm.
Direct Cardiac Effects: Certain medications interfere with electrical signals that regulate heartbeats.

Safe Practices for Patients with AFib

Talk Before Stopping Any Medication: Always consult your healthcare provider.
Use OTC Medicines Carefully: Check labels for decongestants or stimulants.
Monitor Symptoms: Track episodes of palpitations, dizziness, or fatigue.
Ask About Safer Alternatives: Some medications have substitutes less likely to trigger AFib.
Adopt Heart-Healthy Habits: Balanced diet, exercise, weight management, and stress reduction all support rhythm control.

When to Seek Medical Attention

Seek urgent care if AFib is accompanied by:

Chest pain or pressure.
Severe shortness of breath.
Dizziness or fainting.
A rapid or irregular heartbeat lasting more than a few hours.

Conclusion

While AFib has many causes, certain medications—including decongestants, stimulants, asthma drugs, chemotherapy agents, and excessive thyroid hormone—can increase the risk of triggering episodes. People with AFib or risk factors should work closely with their healthcare provider to identify safe treatment options, monitor symptoms, and adopt heart-healthy lifestyle habits. Early awareness and informed decisions can reduce complications and improve quality of life.