Atrial Fibrillation, Hydroxychloroquine, and Lupus

Hydroxychloroquine, also known as Plaquenil or HCQ, reduces the risk of atrial fibrillation for people with lupus by 67% according to a recent study.

HCQ is a commonly-prescribed oral drug for systemic lupus erythematosus (SLE). Originally an anti-malarial drug, HCQ reduces inflammation by blocking immune system receptors and preventing the immune system from activating. This reduces many lupus symptoms, including joint pain. 

And, new studies are also showing that HCQ may also help with atrial fibrillation, a common heart condition.

Atrial Fibrillation and Lupus

Atrial fibrillation is a term for rapid, irregular heartbeats involving the upper chambers of the heart beating irregularly or out-of-sync with the other chambers of the heart. It can feel like a quivering, odd sensation in the chest, or it can be painful. Atrial fibrillation’s causes are many — anything that interferes with the normal muscle contraction of the heart can cause it. This long list includes inflammation, damage to the heart, lungs, or thyroid, and the problems with blood pressure that can come with SLE.

Common symptoms of atrial fibrillation include:

• health palpitations
• physical weakness
• shortness of breath
• pain

Because it makes it more difficult for the body to send oxygen to the muscles that need it, it can lower stamina, preventing Lupus Warriors from getting needed exercise . This lowered exercise, as well as poor blood flow, puts people with lupus and atrial fibrillation at greater risk for heart attacks and blood clots. These blood clots form in the heart, and can spread to organs throughout the body, causing pain, organ damage, and strokes.

Atrial fibrillation is not the only cause of increased stroke risks for Lupus Warriors: Click here to read more about stroke risk and lupus.

Infants suffering from neonatal lupus often have atrial fibrillation problems, and studies show that HCQ can help the child’s odds of avoiding heart problems and long-term disabilities.

Atrial Fibrillation and Hydroxychloroquine

Studies have shown that HCQ has a positive impact on heart function. Although the exact mechanism is unknown HCQ might act on the heart in a similar way to quinidine, a compound related to HCQ. Quinidine prevents the heart muscles from contracting by blocking the sodium and potassium channels that trigger the muscles to contract. This slows down a rapid heartbeat to a more normal rhythm, and makes it easier to keep it in that rhythm.

In a 2018 study, researchers monitored 1646 people with SLE. 754 of those people, approximately half, were actively taking HCQ. The rest did not take HCQ.

When the researchers compared the two groups, they found that only 5 of the HCQ users had a potentially dangerous fibrillation event versus 18 events occurring in the non-users. HCQ lowered the risk of atrial fibrillation by 67% for people using HCQ.

Hydroxychloroquine and Infants

Pregnant women can take HCQ with low risks to their child. In fact, a 2012 study using database analysis reported that mothers using HCQ might be able to prevent their child from developing neonatal lupus, particularly the dangerous heart-related symptoms.

This study examined 257 recorded pregnancies from women who were positive for anti SSA-Ro antibodies, a sign of systemic lupus that can be passed on to their children. Some of these women had previously given birth to children with neonatal lupus. The 40 women who were taking HCQ throughout their pregnancies were 64% less likely to give birth to a child with heart problems or neonatal lupus.

Click here to read more about pregnancy with lupus and how it can affect infants.

Understanding Heart Health and Lupus

The heart is your strongest ally. It feeds nutrients and oxygen to all of your organs and muscles. Work with your lupus treatment team to ensure heart health and see if HCQ could be beneficial. Your treatment team can also help monitor the effectiveness of medications and watch for potential complications.