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Factors that may cause arrhythmia include: Blood sugar levels that are too low or too high Caffeine, illegal drugs, and certain medications Dehydration Low levels of electrolytes, such as potassium, magnesium, or calcium Physical activity Strong emotional stress or anxiety Vomiting or coughing Smoke Use illegal drugs, such as cocaine or amphetamines Drink alcohol more often and more than is recommended (no more than 2 drinks per day for men and 1 drink per day for women) Take certain antibiotics and over-the-counter allergy and cold medicines Talk to your provider about how to prevent arrhythmias