Do Bilastine and Escitalopram cause heart issues?

Question

Hello doctor,

A few months ago, I started taking Bilastine. Just after I began taking it, I started having many more skipped heartbeats than usual and an irregular heart rhythm. One week later, I had ventricular fibrillation which I barely survived. I heard Bilastine can cause anomalies in the heart rhythm but that the chances are low. I also used to take Escitalopram which is also not good for the heart rhythm, but that one I took for years without problems. Could it be that when I combined Escitalopram with Bilastine caused ventricular fibrillation?

Answer 1

Hello,

Welcome to icliniq.com.

I passed carefully through your medical history and would like to explain that your previous medications could have played a role in triggering the cardiac arrhythmia episode. Escitalopram has been mentioned more frequently as a cause of arrhythmic events as it may cause QTc interval prolongation on ECG (electrocardiography). Bilastine in fact has not been confirmed as a direct proarrhythmic agent. Anyways, a combination could have produced an exaggerated effect. From the other side, separated cardiomyopathy, serving as an important arrhythmogenic substrate cannot be excluded. A cardiac MRI (magnetic resonance imaging) study would have been the most appropriate test to carefully characterize the cardiac tissues. But, actually after ICD (implantable cardioverter defibrillator) implantation, some artifacts would be present during that study and the conclusions may be compromised. I recommend following QTc interval evaluation with periodic ECG, and checking also blood electrolytes level. In case of a certain cardiomyopathy, genetic testing could be helpful. I hope this helps.