Antiarrhythmic Drugs: Age, Race, and Gender Effects

Women have a higher risk of developing torsade de pointes when taking QT-prolonging antiarrhythmic drugs. Elderly women with heart failure may have the highest risk of proarrhythmia. Greater caution should be used when treating women with these drugs, especially when additional risk factors for developing proarrhythmia are present. Women with congenital heart disease frequently experience arrhythmias during pregnancy, and use of antiarrhythmic drugs in this setting poses a special challenge. In the elderly population, the risk of antiarrhythmic drug use may outweigh the benefit, especially in individuals with asymptomatic arrhythmias. Limited data suggest potential ethnic differences in arrhythmic substrates and in proarrhythmic response to antiarrhythmic drugs.