Electrocardiographic Markers of Arrhythmogenic Risk in Synthetic Cannabinoids Users

Cannabis Cannabinoid Res. 2023 Aug;8(4):691-697. doi: 10.1089/can.2021.0193. Epub 2022 Apr 29.


Background: Synthetic cannabinoids (SCs) users appeared to have heightened risk for cardiac arrhythmias; however, current line of research is insufficient in terms of demonstrating both conventional and novel electrocardiographic arrhythmia risk indicators in this population. Objective(s): We aimed to investigate P-wave dispersion (Pwd), corrected QT interval (QTc), QTc dispersion (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT ratio, corrected JT interval (JTc), and JTc dispersion (JTcd), which are shown among the risk factors for emergence of an arrhythmia, among SCs users, suggestive of possible adverse effects of SCs on the cardiac rhythm. Methods: Forty-one male SCs user patients who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use disorder criteria and 41 healthy male controls included in the study. Substance-related characteristics were recorded. Electrocardiography recordings under standardized procedure of all participants were performed and arrhythmia risk markers were calculated from electrocardiograms (ECGs). Results: Age and heart rate per minute did not significantly differ between the groups. SCs user group had significantly higher Pwd, QTc, QTcd, Tp-e, Tp-e/QTc ratio, JTc, and JTcd values compared with controls. Among risk markers, only Pwd was significantly correlated with duration of SCs use. Conclusions: Alterations in ECG-derived markers of arrhythmia, which are acquired through an easy and cheap method, should be evaluated for the prediction and prevention of severe cardiac conditions in patients with SCs use.

Keywords: arrhythmia; electrocardiogram; intoxication; synthetic cannabinoids.

MeSH terms

  • Arrhythmias, Cardiac / chemically induced
  • Arrhythmias, Cardiac / diagnosis
  • Cannabinoids* / adverse effects
  • Electrocardiography / adverse effects
  • Electrocardiography / methods
  • Heart Diseases* / chemically induced
  • Heart Diseases* / complications
  • Humans
  • Male
  • Risk Factors


  • Cannabinoids