Creatine and Afib

Greetings Drs:
I am familiar with the near universal evidence that creatine monohydrate is safe with most of the side effects related to gastrointestinal tolerance, etc. About 18 months ago I had a cardiac ablation to deal with occasional persistent periods of Afib (out of rhythm heart beat lasting 2-12 hours)–something that had occurred once every few years had increased to several times a week. The condition predates my training history and use of creatine, but I noticed what I thought was a worsening of the number and duration of episodes while on creatine, but I convinced myself that it was probably just a coincidence. Since the ablation and healing period, I have had no Afib episodes, but have had an occasional missed heart beat–something my cardiologist is not concerned with. I noticed when I got back on creatine recently, these missed heart beats seemed to increase and cluster, coming and going more often. I stopped taking creatine again and after a few weeks they have mostly gone away. I do not believe I am nocebo-ing myself: if this was a real issue there would be more than the anecdotal things you find online. And I absolutely do not need to take creatine, but I was wondering if there is any potential mechanism through which creatine could disrupt the heart rhythm of someone with a history of Afib? I know since there is no real evidence that this would likely be conjecture, but now I have a mostly academic interest in this as a possibility.
Thanks for any thoughts!

There are a few case reports, but no known mechanisms by which creatine monohydrate causes a cardiac arrhythmia. Sounds like it could be related in your situation, but also possible your existing condition is ebbing and flowing. Using the Naranjo Adverse Drug Reaction Probability Assessment , your reaction is somewhere in the probable range. That said, without any control of your afib, I’d lean more towards that than anything else.

Thanks, Jordan for the quick response. Probably should just avoid creatine. I was reading something about creatine here (Role of Creatine in the Heart: Health and Disease - PMC) that was talking about creatine’s role in heart contraction…but as a professor of architecture I don’t have the scientific background to know what this means.

Creatine is an energy source and potential anti-oxidant in all cells including cardiac tissue. Some evidence for using it post heart attack or other damage to the heart.