07 June 2024

Five percent of cardiac arrests have been linked to energy drink consumption

A review of nearly 150 cases of sudden cardiac arrest found that in five per cent of patients, the arrest was associated with regular consumption of energy drinks. These patients had prolonged QT syndrome, ventricular tachycardia and idiopathic ventricular fibrillation. Most of the arrests occurred during sports training, before which the patients consumed energy drinks. The analysis is published in the journal Heart Rhythm.

The energy drink market has been growing steadily over the past few years. With new brands targeting younger age groups, energy drinks have become the second most consumed supplement after multivitamins among adolescents and young adults in some countries. Typically, these drinks contain between 80 and 300 milligrams of caffeine per serving; in comparison, a cup of brewed coffee contains an average of 100 milligrams of caffeine. However, most energy drinks contain other stimulating ingredients in addition to caffeine.

Previous studies have shown a potential correlation between high caffeine consumption (more than 10 cups of coffee a day) and sudden cardiac arrest. In addition, people with inherited heart disease have an inherently higher risk of developing cardiac arrest. These conditions include, but are not limited to, prolonged QT syndrome, catecholaminergic polymorphic ventricular tachycardia and idiopathic ventricular fibrillation. The surge in popularity of energy drinks, the increase in caffeine content per serving, and the presence of several unregulated ingredients have raised concerns among doctors and experts about their consumption by patients with inherited heart disease.

A team of scientists led by Michael Ackerman of the Mayo Clinic studied the potential temporal relationship between energy drink consumption and risk of cardiac complications in patients with known inherited heart disease. The study included 144 survivors of sudden cardiac arrest, of whom seven patients (six women, one man, mean age at the time of cardiac arrest 29 ± 8 years) showed a temporal correlation between energy drink consumption and sudden cardiac arrest. Energy drink consumption was assessed as frequent or infrequent based on patient self-report. Despite its retrospective nature, the researchers recognised the reliability of the data on energy drink consumption as extremely high, as it was part of the standard collection of patient history.

Three of the seven patients studied were diagnosed with unexplained cardiac arrest with idiopathic atrial fibrillation, two with catecholaminergic polymorphic ventricular tachycardia, and another two with prolonged QT interval syndrome. Three patients reported frequent consumption of energy drinks, while the other four patients consumed them infrequently. The time interval between energy drink consumption and cardiac arrest ranged from 12 hours to immediately before the event. Six patients required defibrillation, one patient indirect cardiac massage with precardiac shock was sufficient. Six patients subsequently required implantable cardioverter placement and two required left ventricular sympathetic denervation.

The first patient was a 32-year-old woman who had given birth 11 weeks earlier. She had consumed an energy drink before exercise and went into cardiac arrest a few hours later when she was already in bed. She had no history of cardiac symptoms or complications. The second patient was a 37-year-old woman who experienced respiratory disturbances in the middle of the night several hours after consuming an energy drink. The third patient was a 20-year-old man who usually consumed the energy drink before workouts, which were relatively intense because he was involved in athletics. On the day of the cardiac arrest, he collapsed during a sprint run.

The fourth patient was a 28-year-old woman who drank large amounts of highly caffeinated energy drinks every day. She suddenly collapsed when she had a conflict with colleagues at her workplace. The fifth patient was a 21-year-old woman with an established diagnosis of prolonged QT interval syndrome and a history of cardiac arrest. Although she hardly ever consumed energy drinks, on the day of another cardiac arrest, the patient drank one. On the same day, she smoked e-cigarettes, subsequently collapsing at her workplace during an argument with a colleague. The sixth patient was a 42-year-old woman who also fainted during a workout before which she drank an energy drink. The last patient was a 26-year-old woman who drank an energy drink immediately after a workout and passed out in the passenger seat of a car.

According to the doctors, these cases suggest a link between energy drink consumption and the risk of cardiac arrest in people with a genetic predisposition to it. While the sample size of the analysis is not scalable, this work lays the foundation for future research.

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