Unravelling Drug-Induced Arrhythmias: A Case Series Analysis

Varun  A; Kirubhakaran  K; Ranga Bashyam  SR

doi:10.18502/jimc.v8i3.18808

Varun A Department of General Medicine, Vinayaka Mission’s Kirupanandha Varriyar Medical College and Hospital, Salem, Tamil Nadu, India
Kirubhakaran K Department of General Medicine, Vinayaka Mission’s Kirupanandha Varriyar Medical College and Hospital, Salem, Tamil Nadu, India
Ranga Bashyam SR Department of General Medicine, Vinayaka Mission’s Kirupanandha Varriyar Medical College and Hospital, Salem, Tamil Nadu, India

DOI: https://doi.org/10.18502/jimc.v8i3.18808

Keywords: Amiodarone, Amitriptyline, Arrhythmias, Cardiac, Cardiovascular Diseases, Logistic Models, Patient Safety, Polypharmacy, Retrospective Studies, Sertraline

Abstract

Background: Drug-induced arrhythmias pose a significant clinical challenge, with potential life-threatening complications such as cardiac arrest and sudden cardiac death. Understanding the epidemiology, implicated drugs, and clinical characteristics of drug-induced arrhythmias is crucial for optimizing patient care and improving outcomes.

Methods: A retrospective cohort study involving 500 arrhythmia-diagnosed patients was conducted. Drug-induced cases were identified through meticulous medication histories. Various demographic and clinical variables were collected, and statistical analyses, including logistic regression, explored the association between drug exposure and arrhythmia development.

Results: Among the 500 patients diagnosed with arrhythmias, 115 cases (23%) were attributed to pharmacological agents. Notably, amiodarone was significantly associated with arrhythmia development (p<0.001, OR=2.5, 95% CI 1.8–3.4), as were ciprofloxacin (p=0.006, OR=1.8, 95% CI 1.2–2.7), sertraline (p=0.014, OR=1.6, 95% CI 1.1–2.3), and amitriptyline (p<0.05, OR=1.6, 95% CI 1.1–2.3). Advanced age (>65 years) was significantly associated with a higher risk of drug-induced arrhythmias (OR=2.5, p<0.001), similar to a history of cardiovascular disease (OR=3.1, p<0.001). Polypharmacy (OR=2.8, p =0.002) also emerged as an independent risk factor.

Conclusion: Understanding the complexity of drug-induced arrhythmias is crucial for patient care. Tailored risk assessment and management strategies are imperative to mitigate adverse outcomes associated with these arrhythmias, especially in high-risk patient populations. Incorporating personalized approaches into clinical practice can enhance patient safety and improve outcomes in individuals prone to drug-induced arrhythmias.