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Atrial Fibrillation in Healthy Adolescents After Highly Caffeinated Beverage Consumption: Two Case Reports

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Atrial Fibrillation in Healthy Adolescents After Highly Caffeinated Beverage Consumption: Two Case Reports

Jennifer R Di Rocco et al. J Med Case Rep.

Abstract

Introduction: Energy drinks and highly caffeinated drinks comprise some of the fastest growing products of the beverage industry, often targeting teenagers and young adults. Cardiac arrhythmias in children related to high caffeine consumption have not been well described in the literature. This case series describes the possible association between the consumption of highly caffeinated drinks and the subsequent development of atrial fibrillation in the adolescent population.

Case presentations: We report the cases of two Caucasian adolescent boys of 14 and 16 years of age at the time of presentation, each without a significant cardiac history, who presented with palpitations or vague chest discomfort or both after a recent history of excessive caffeine consumption. Both were found to have atrial fibrillation on electrocardiogram; one patient required digoxin to restore a normal sinus rhythm, and the other self-converted after intravenous fluid administration.

Conclusion: With the increasing popularity of energy drinks in the pediatric and adolescent population, physicians should be aware of the arrhythmogenic potential associated with highly caffeinated beverage consumption. It is important for pediatricians to understand the lack of regulation in the caffeine content and other ingredients of these high-energy beverages and their complications so that parents and children can be educated about the risk of cardiac arrhythmias with excessive energy drink consumption.

Figures

Figure 1
Figure 1
Electrocardiogram showing narrow-complex tachycardia with atrial fibrillation and occasional atrial flutter with irregularly irregular ventricular response. Heart rate, 122 beats per minute; QRS, 88 ms; QTc, 433 ms.
Figure 2
Figure 2
ECG showing normal sinus rhythm restored to 65 beats per minute after a dose of digoxin. PR interval, 129 ms; QRS, 100 ms; QTc, 398 ms.
Figure 3
Figure 3
ECG showing chaotic atrial tachycardia/atrial fibrillation with rapid ventricular response at a rate of 166 beats per minute. QRS, 97 ms; QTc, 492 ms.
Figure 4
Figure 4
ECG showing restoration of normal sinus rhythm to 85 beats per minute after intravenous fluids. PR interval, 117 ms; QRS, 96 ms; QTc, 416 ms.
Figure 5
Figure 5
Caffeine content of common commercial beverages as compared with FDA-approved safe content of up to 0.02% (6 mg/ounce).

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