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Aim: There have been concerns about links between medication for attention deficit hyperactivity disorder (ADHD) and cardiac events in children and young people. Our aim was to identify any associations.

Method: This Swedish case–control study used national register data to identify individuals aged 5–30 years who received their first diagnosis of a cardiac arrest, arrhythmia, fainting or collapse in 2006–2018. Each case was matched with five controls, by age, sex and region. Associations between ADHD medication and cardiac events were assessed using adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adjustments were made for concomitant medications and comorbidities, including congenital heart disease (CHD).

Results: We studied 112 605 cases (57.9% female), with a median age of 20 years (range 5–30), and 563 024 matched controls. Using ADHD medication was associated with cardiac events (aOR 1.63, 95% CI 1.47–1.81) across sexes and age groups. Undefined arrhythmias had the strongest association (aOR 2.66, 95% CI 2.27–3.13). Cardiac arrests and defined arrhythmias had no associations. Long-term medication was associated with an increased risk (aOR 1.20, 95% CI 1.12–1.28). CHD had no impact.

Conclusion: ADHD medication was associated with cardiac events, particularly undefined arrhythmias. CHD did not increase the risk.