Sleep Medications Containing Melatonin can Potentially Induce Ventricular Arrhythmias in Structurally Normal Hearts: A 2-Patient Report

Idiopathic ventricular arrhythmias (IVAs) are relatively common in the general population and usually have a good prognosis. However, frequent premature ventricular contractions (PVCs) can lower the quality of life (in symptomatic cases) and can cause cardiomyopathy and sudden cardiac death. In this report, we demonstrate a novel trigger for IVAs. Melatonin use for treating sleep disorders has increased significantly in recent years. We provide here the first human evidence of its proarrhythmic effect by presenting 2 patients (with normal myocardium) with symptomatic PVCs, while on melatonin. Discontinuation of melatonin stopped PVCs in both patients. Our findings highlight the importance of identifying precipitating factors for IVAs.