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Nicotine gum-induced atrial fibrillation
Nagaraju L Choragudi1, Wilbert S Aronow, Albert J DeLuca
1Cardiology Division, Department of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Heart Disease (Hagerstown, Md.)
|April 26, 2003
Summary
This case study suggests a link between high nicotine gum consumption and atrial fibrillation. Reducing nicotine intake resolved the patient's heart rhythm issues.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Atrial fibrillation (AF) is a common cardiac arrhythmia.
- Nicotine replacement therapies, such as nicotine polacrilex gum, are widely used for smoking cessation.
Observation:
- A 39-year-old man presented with new-onset atrial fibrillation and rapid ventricular rate.
- He reported chewing over one piece of nicotine polacrilex gum per hour for the week preceding symptom onset, with 7 months of prior use.
- No other cause for atrial fibrillation was identified during hospitalization.
Findings:
- The patient was successfully cardioverted to sinus rhythm.
- Upon cessation of nicotine polacrilex gum use, the patient remained in sinus rhythm with no recurrence of palpitations at 6-month follow-up.
- A temporal relationship between increased nicotine gum consumption and the onset of atrial fibrillation suggests a potential causal link.
Implications:
- Excessive nicotine intake from polacrilex gum may precipitate atrial fibrillation in susceptible individuals.
- This case highlights the importance of considering nicotine replacement therapy as a potential trigger for cardiac arrhythmias.
- Further research is warranted to explore the dose-dependent effects of nicotine on cardiac electrophysiology.