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These medications are known to be associated with bradycardia given their mechanism of action of increasing acetylcholine (ACh). However, in March 2015, donepezil was added to the CredibleMeds \u201cknown\u2010risk\u201d category, a list where medications have a documented risk for acquired long\u2010QT syndrome (ALQTS) and torsades de pointes (TdP) \u2013 a malignant ventricular arrhythmia that is a different adverse event than bradycardia (and is not necessarily associated with ACh action). The purpose of this article is to review the three AChEIs, especially with regards to mechanistic differences that may explain why only donepezil poses this risk; several pharmacological mechanisms may explain why. However, from an empirical point\u2010of\u2010view, aside from some case\u2010reports, only a limited number of studies have generated relevant information regarding AChEIs' and electrocardiogram findings; none have specifically compared donepezil against galantamine or rivastigmine for malignant arrhythmias such as TdP. Currently, the choice of one of the three AChEIs for treatment of AD symptoms is primarily dependent upon clinician and patient preference. However, clinicians should be aware of the potential increased risk associated with donepezil. There is a need to examine the comparative risk of malignant arrhythmias among AChEIs users in real\u2010world practice; this may have important implications with regards to changes in AChEI prescribing patterns.<\/jats:p>","DOI":"10.1002\/prp2.622","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T11:59:44Z","timestamp":1595332784000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparative risk of cardiac arrhythmias associated with acetylcholinesterase inhibitors used in treatment of dementias \u2013 A narrative review"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2224-6282","authenticated-orcid":false,"given":"Yichang","family":"Huang","sequence":"first","affiliation":[{"name":"School of Pharmacy Faculty of Science University of Waterloo Kitchener Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2426-9528","authenticated-orcid":false,"given":"Mhd. 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