Cardiovascular risk of energy drinks: Caffeine and taurine facilitate ventricular arrhythmias in a sensitive whole‐heart model

Abstract

Background Several case reports have suggested an increased risk of sudden cardiac death due to energy drinks. Therefore, the purpose of this study was to assess acute electrophysiologic effects of caffeine and taurine, two of the main ingredients of energy drinks, in an experimental whole‐heart model. Methods and Results Twenty‐five rabbit hearts were excised, retrogradely perfused, and assigned to two groups. Hearts were perfused with caffeine (2, 10, and 50 µM) or taurine (2, 10, and 50 µM) after generating baseline data. Eight monophasic action potentials and electrocardiography recordings showed a significant abbreviation of action potential duration (APD90), QT interval, and effective refractory periods (ERP) after caffeine treatment. With taurine, cardiac repolarization duration and ERP were significantly shortened. A ventricular vulnerability was assessed by a predefined pacing protocol. With caffeine, we observed a trend towards more ventricular arrhythmias in a dose‐dependent manner. After treatment with taurine, significantly more episodes of ventricular arrhythmias occurred. Conclusion In this experimental whole‐heart study, treatment with caffeine and taurine provoked ventricular arrhythmias. The underlying mechanism was an abbreviation of cardiac repolarizations and effective refractory periods that may facilitate re‐entry and thereby provokes arrhythmias. These findings help to understand the potentially hazardous and fatal outcomes after intoxication with energy drinks.

The Dark Side of Energy Drinks: A Comprehensive Review of Their Impact on the Human Body

“…Possible adverse effects of caffeine and taurine on cardiac electrophysiology were investigated using twenty-five rabbits as an animal model [ 129 ]. The hearts of animals perfused with caffeine and taurine showed shortened repolarisation times and refractory periods on the ECG trace, followed by ventricular arrhythmias, confirming the potential arrhythmogenic effect of these substances.…”

Genç yetişkinlerde elektrofizyolojik ve hemodinamik parametreler üzerine kafeinli içeceklerin akut etkileri

“…These result in a shortening of the repolarization period which explains the short QT interval, and short atrial and ventricular effective refractory periods. Ellermann et al 43 suggested that high-dose taurine may be responsible for the abbreviation of effective refractory periods. Moreover, there were some conflicting data in the literature which reported unchanged or increased QTc interval after ED consumption 7,8,23,44 .…”

Sex Related Differences in the Complex Relationship between Coffee, Caffeine and Atrial Fibrillation

“…Young people tend to take caffeine through energy drinks or soft drinks. The incidence of atrial fibrillation in young people is very low; however, some case reports illustrate arrhythmic episodes as a consequence of the assumption of high doses of energy drinks [5,[94][95][96][97][98][99].…”