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STATE-OF-THE-ART PAPER

Drug-induced atrial fibrillation

Cornelis S. van der Hooft, MD^*,, Jan Heeringa, MD^*, Gerard van Herpen, MD, PhD, Jan A. Kors, PhD, J. Herre Kingma, MD, PhD^, and Bruno H. Ch. Stricker, MB, PhD^*,,*

^* Pharmaco-epidemiology Unit, Department of Epidemiology & Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands
Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
Inspectorate for Health Care, The Hague, the Netherlands
Department of Clinical Pharmacology, University of Groningen, Groningen, the Netherlands

Manuscript received May 28, 2004; revised manuscript received August 6, 2004, accepted August 16, 2004.

^* Reprint requests and correspondence: Dr. Bruno H. Ch. Stricker, Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, the Netherlands (Email: b.stricker{at}erasmusmc.nl).

Atrial fibrillation (AF) is the most common sustained rhythm disorder observed in clinical practice and predominantly associated with cardiovascular disorders such as coronary heart disease and hypertension. However, several classes of drugs may induce AF in patients without apparent heart disease or may precipitate the onset of AF in patients with preexisting heart disease. We reviewed the literature on drug-induced AF, using the PubMed/Medline and Micromedex databases and lateral references. Successively, we discuss the potential role in the onset of AF of cardiovascular drugs, respiratory system drugs, cytostatics, central nervous system drugs, genitourinary system drugs, and some miscellaneous agents. Drug-induced AF may play a role in only a minority of the patients presenting with AF. Nevertheless, it is important to recognize drugs or other agents as a potential cause, especially in the elderly, because increasing age is associated with multiple drug use and a high incidence of AF. This may contribute to timely diagnosis and management of drug-induced AF.

Abbreviations and Acronyms   AF = atrial fibrillation   CABG = coronary artery bypass graft   SLE = systemic lupus erythematosus   SR = sinus rhythm   SVT = supraventricular tachycardia

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