Is there a risk of heart rhythm problems on bisphosphonates?
Atrial fibrillation is a disturbance of the rhythm of the heart which is commonly seen in older individuals. Untreated, it can result in low energy, shortness of breath and occasionally stroke. Most often it is due to hardening of the arteries and heart disease but not from medications. It often can be easily and effectively treated. The question of atrial fibrillation associated with bisphosphonate therapy arose when, in one trial, there was a small excess of serious atrial fibrillation associated with intravenous zoledronic acid therapy as compared to not taking this therapy. The numbers were small and further studies were undertaken. There were no heart rhythm problems seen in patients treated with other bisphosphonates, even in very elderly and frail patients or those taking very high doses of medication. Indeed, in frail elderly patients after hip fracture, annual intravenous zoledronic acid was seen to have reduced deaths by 28% as compared to only calcium and vitamin D. In this
