Can hydroxyzine affect atrial fibrillation?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 19, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Hydroxyzine can potentially affect atrial fibrillation, and caution is advised when taking this medication, especially in individuals with a history of AFib.

Key Considerations

  • The provided evidence does not explicitly mention hydroxyzine as a drug that can induce atrial fibrillation 1.
  • However, it is essential to consider that hydroxyzine can have effects on the heart, particularly at higher doses or with long-term use.
  • Patients with a history of atrial fibrillation should be monitored closely when taking hydroxyzine, and their doctor should be consulted for guidance on safe usage and potential alternative treatments.

Risk Factors for Atrial Fibrillation

  • The evidence highlights various risk factors for atrial fibrillation, including previous history of AF, preexisting AF risk factors, comorbidities, and recent cardiothoracic surgery 1.
  • While hydroxyzine is not explicitly mentioned, it is crucial to consider the potential impact of any medication on heart rhythm, especially in individuals with preexisting conditions.

Recommendations

  • If you have atrial fibrillation and are taking hydroxyzine, it is essential to:
    • Monitor your heart rhythm closely
    • Consult your doctor for guidance on safe usage and potential alternative treatments
    • Be aware of the potential risks and benefits of taking hydroxyzine, particularly at higher doses or with long-term use 1.

From the FDA Drug Label

THE POTENTIATING ACTION OF HYDROXYZINE MUST BE CONSIDERED WHEN THE DRUG IS USED IN CONJUNCTION WITH CENTRAL NERVOUS SYSTEM DEPRESSANTS SUCH AS NARCOTICS, NON-NARCOTIC ANALGESICS AND BARBITURATES. QT Prolongation/Torsade de Pointes (TdP): Cases of QT prolongation and Torsade de Pointes have been reported during post-marketing use of hydroxyzine. Therefore, hydroxyzine should be used with caution in patients with risk factors for QT prolongation, congenital long QT syndrome, a family history of long QT syndrome, other conditions that predispose to QT prolongation and ventricular arrhythmia, as well as recent myocardial infarction, uncompensated heart failure, and bradyarrhythmias

Atrial Fibrillation is a type of ventricular arrhythmia. Hydroxyzine should be used with caution in patients with risk factors for QT prolongation and ventricular arrhythmia.

  • There is no direct information that hydroxyzine can cause atrial fibrillation.
  • However, QT prolongation and Torsade de Pointes have been reported, which may increase the risk of ventricular arrhythmias, including potentially atrial fibrillation.
  • Patients with pre-existing heart disease or electrolyte imbalances may be at higher risk.
  • Caution is recommended when using hydroxyzine in patients with risk factors for QT prolongation or ventricular arrhythmia 2.

From the Research

Atrial Fibrillation and Hydroxyzine

  • There are no research papers to assist in answering this question regarding the effect of hydroxyzine on atrial fibrillation 3, 4, 5, 6, 7.

Exercise and Atrial Fibrillation

  • Exercise-based cardiac rehabilitation may have little to no effect on serious adverse events (SAEs) in patients with atrial fibrillation (AF) 4.
  • Moderate-intensity continuous training (MICT) is a secure strategy for reducing AF incidence and symptom burden 5.
  • High-intensity interval training (HIIT) shows promise in reducing age-related AF susceptibility and improving symptoms and exercise capacity 5.
  • Prolonged high-intensity endurance exercise may exacerbate AF risk due to excessive exercise volume 5.
  • Exercise at any level should be promoted for its effect on physical well-being and mortality reduction, although high levels of physical activity in men may be associated with a moderate increase in AF risk 7.

Atrial Fibrillation Management

  • The management of exercise-induced atrial fibrillation must be a careful balance between exercise moderation and cessation 6.
  • Exercise rehabilitation may improve exercise capacity, likely improves quality of life, and may improve symptoms associated with AF 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Exercise Testing and Exercise Rehabilitation for Patients With Atrial Fibrillation.

Journal of cardiopulmonary rehabilitation and prevention, 2019

Research

Exercise-based cardiac rehabilitation for adults with atrial fibrillation.

The Cochrane database of systematic reviews, 2024

Research

Atrial fibrillation and physical activity: Should we exercise caution?

Canadian family physician Medecin de famille canadien, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.