I added an extra 100 mg to my phenytoin dosage a week ago but it is possible that my actual blood levels increased more than that in that short space of time. I have a prolapsed heart valve, which I take medication for, but I've never had a real problem with arrhythmia before. At its worst, I'd have one small event a day for two weeks or so over my entire lifetime. Last night I started having almost constant arrhythmia, which has never happened before. It seems to be improving for a couple of hours after my phenytoin dose and then getting worse as I reach a trough. If polytherapy or phenytoin are to blame, surely my arrhythmia should be better during a trough? Or does it not work that way? It becomes confusing because phenytoin can cause and treat arrhythmia. And do arrhythmias always mean you have to quit your AED? Anyone with a heart condition had worsening arrhythmia from AEDs? If so, which drugs and what cardiac problem?