An Arrhythmia Story

September 26, 2013 – Thursday

An Arrhythmia Story                  – by Jim Lewis, Pharmacist

By chance, I met up with an old friend in the cafeteria of a hospital where I was working.  I had not expected to see him there, but asked if I could join him; I sat down and we talked.

It is my hope that his story will help someone you know as it has helped some folks that I know.  His story is as follows.

He was at the hospital for a check-up with his cardiologist.  He had suffered from an arrhythmia which was not being controlled by medication.  His cardiologist had recommended a pacemaker and he had undergone the procedure to have the pacemaker implanted.  After the implant he was still having arrhythmia so the cardiologist suspected that one of the pacemaker leads was not functioning properly, so he underwent another procedure to reposition the suspected lead.  After the second procedure he was still experiencing cardiac arrhythmia.

By chance, he met an old friend who had been through the same ordeal with a pacemaker implant, the repositioning of a lead, and still having arrhythmia.  His friend had been discussing his problem with his pharmacist who asked if he was still drinking coffee.  He responded that, yes, he still drank coffee.  The pharmacist said that caffeine might contribute to arrhythmia and that the friend should consider eliminating caffeine from his diet.  The friend did so, and the arrhythmia went away.

On hearing the story, my friend decided to eliminate caffeine and he reported a similar result; no more arrhythmia.

Here are some things that I would like for you to consider: coffee is not the only source of caffeine.  Caffeine is not the only stimulant that can contribute to cardiac arrhythmia.  There are several drinks that include caffeine and there are several over-the-counter medications that contain stimulants.

Think about all the stimulant drinks that promise to wake you up; caffeine is the main ingredient.  Think about the over-the-counter decongestants that are advertised widely to stop your runny nose and allergies.  The most egregious (outstandingly bad) example is the decongestant class of medications that contain pseudo-ephedrine.  Some of those contain 240 mg (two hundred forty milligrams) of pseudo-ephedrine, a stimulant.  I am a pharmacist and over the years I have taken pseudo-ephedrine for nasal decongestion in a dose of 30 mg (thirty milligrams) and it works just fine.  Remember that pseudo-ephedrine is used as the main ingredient in the illegal substance crystal methamphetamine, a powerful stimulant drug.

It is my opinion that 240 mg of pseudo-ephedrine taken for a runny nose daily is a very dangerous medication and should be removed from the over-the-counter market by the FDA.

The bottom line is this: caffeine and stimulants may contribute to cardiac arrhythmia.  I suggest strongly that if you are experiencing diagnosed arrhythmia, you eliminate caffeine and stimulants before you have a pacemaker implant.