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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Comparative risk of arrhythmias associated with systemic antifungal agents: a disproportionality analysis of the

Xiaohu Yang1,2, Hao Li1,2, Kai Liu1,2

  • 1Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.

Frontiers in Pharmacology
|June 11, 2026
PubMed
Abstract

Insights

Systemic antifungal drugs like itraconazole, fluconazole, and posaconazole show increased cardiac arrhythmia risks. Safer alternatives include micafungin, flucytosine, and isavuconazole, requiring personalized risk assessment for safe medication practices.

Area of Science:

  • Pharmacology
  • Cardiology
  • Drug Safety

Background:

  • The cardiac safety of systemic antifungal agents requires further investigation.
  • Real-world data on arrhythmogenic toxicity is limited.
  • Understanding drug-induced cardiac events is crucial for patient safety.

Purpose of the Study:

  • To evaluate the cardiac safety profile of nine systemic antifungal drugs.
  • To identify potential arrhythmogenic risks associated with these agents.
  • To provide evidence-based guidance for safe clinical use.

Main Methods:

  • Utilized the US Food and Drug Administration Adverse Event Reporting System (FAERS) database.
  • Analyzed adverse event reports using four disproportionality algorithms: ROR, PRR, MGPS, and BCPNN.
  • Classified events using Standardized MedDRA Queries (SMQs) for arrhythmogenic toxicity.

Main Results:

  • Itraconazole, fluconazole, and posaconazole were associated with significant arrhythmogenic signals.
  • Fluconazole showed the highest risk for Torsade de pointes/QT prolongation (ROR 14.55).
  • Micafungin, flucytosine, and isavuconazole exhibited negative or no significant arrhythmogenic signals.

Conclusions:

  • Itraconazole, fluconazole, and posaconazole present a higher risk of cardiac arrhythmias.
  • Micafungin, flucytosine, and isavuconazole appear safer regarding arrhythmogenic toxicity.
  • Personalized risk-benefit assessment is essential for selecting systemic antifungal therapy.
Keywords:
FAERS databaseadverse reactionsarrhythmiassignal miningsystemic antifungal agents

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