ILRs may unmask "hidden" arrhythmia burden in patients on psychotropic drugs: JAMA study

Patients with mental disorders have increased risk of premature death compared with the background population. One suspected cause for this observation may be undiagnosed but life threatening arrhythmias due to psychotropic medications. In a first of its kind study, Norgaard et al assessed the incidence of arrhythmia among patients receiving psychotropic medication using the new implantable loop recorder (ILR) modality for long-term electrocardiographic monitoring. Authors have found that arrhythmias occurred in a proportion of patients (21%) on psychotropic medications, comparable to that of patients suspected to have epilepsy (21%) and smaller than the proportion of patients with unexplained syncope (35%).

This cohort study included 20 patients with mental disorders who received psychotropic drugs for at least 6 months and had no history of heart disease.

All patients received at least 1 psychotropic medication: 19 received antipsychotics; 6, antidepressants; 2, valproate; and 7, benzodiazepines. A total of 6 patients had concomitant substance use. All presented with sinus rhythm without bundle branch block and had normal echocardiographic findings at study entry and termination.