Elsevier

Clinical Nutrition

Volume 37, Issue 3, June 2018, Pages 1073-1074
Clinical Nutrition

Short Communication
Energy Drinks and atrial fibrillation in young adults

https://doi.org/10.1016/j.clnu.2017.05.002Get rights and content

Summary

The present paper evaluates the association between Energy Drinks (EDs) and occurrence of atrial fibrillation (AF) in young people. Data from three clinical cases of AF after EDs consumption are reported. All patients presented with palpitations, nausea and anxiety. ECG showed AF with high ventricular response (135–170 bpm range frequency). Anamnestic record reported a high consumption of EDs during the previous 8 h from the onset of AF. In one case ED was associated with a moderate quantity of alcohol. Patients were successfully cardioverted both spontaneously and after pharmacological treatment. After cardioversion: the ECG and echocardiogram appeared normal in all patients; the toxicological tests and the laboratory analyses resulted negative.

Our experience suggests that larger consumption of EDs, especially when combined with alcoholic beverages, could act as a trigger in the development of AF in young patients. This action may be caused by the synergic effect of caffeine and other substances present in EDs. Following the increasing consumption of EDs in young people, we suggest a careful attention to cardiac complications.

Introduction

Today the consumption of Energy Drinks (EDs) spreads mostly among young people, who often consider the ingestion of large amount of such substances harmless [1]. Their adverse effects, not yet completely known, are usually considered secondary to a high concentration of caffeine. Here we focus on a particular acute cardiac complication of EDs overconsumption: the high rate atrial fibrillation (AF). Our experience, even if limited to three cases, can be considered a typical example of this condition.

Section snippets

Case #1

A 22-year-old man, with a negative family, personal, and pharmacological history, was referred to our emergency department for a precordial oppressive sensation, palpitations, increasing anxiety, and nausea. Three hours before, he has consumed 750 ml of ED. At admission, blood pressure was 110/65, with an accelerated and arrhythmic pulse rate. No other thoracic or abdominal physical signs were present. An ECG revealed a high rate atrial fibrillation at 135 bpm. The laboratory tests of thyroid,

Discussion

We have reported a common feature in all 3 cases: a rapid consumption of a big amount of EDs. These beverages contain 50 mg/100 ml of caffeine, taurine, carnitine and herbal extracts such as ginseng, ginkgo biloba, and guaranà (containing caffeine plus teobromine and theophylline). The toxicity of the EDs abuse was enhanced in case #2 by a recent increase in caffeine consumption, and in case #3 by a sporadic ingestion of alcohol.

In all cases a sign was predominant: the paroxysmal atrial

Conflict of interest

None.

Acknowledgements

We would like to thank Doctor Matteo Ballerini Puviani for his support in reviewing the article.

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