This study evaluated the risk of arrhythmias associated with inhaled anticholinergic (IAC) use in young patients (5-24 years of age) with asthma during a 13-year period (ended in 2010. Among almost 300,000 patients with asthma, 7656 cases were matched to controls (1:10 ratio). Most of patients were 12 years or older (73.3%). Active exposure to inhaled anticholinergic was observed in 0.69% of cases and 0.18% of controls.
Active use was associated with a 1.56-fold increase in arrhythmia risk, which was significant only among the high-dose users of IACs (more than 0.114 mg of ipratropium equivalents) who had a 69% increase in risk.
Use of ipratropium bromide (Atrovent) was associated with an increased risk of arrhythmias in 12-24-year-old patients with asthma.
Reference:
Risk of Arrhythmias Associated with Ipratropium Bromide in Children, Adolescents, and Young Adults with Asthma: A Nested Case-Control Study. Adimadhyam S, Schumock GT, Walton S, Joo M, McKell J, Lee TA. Pharmacotherapy. 2013 Aug 5. doi: 10.1002/phar.1336.
http://www.ncbi.nlm.nih.gov/pubmed/23918239
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