Electrocardiogram Abnormalities of Caffeine Overdose

Multiple and Concurrent Arrhythmia

“…2,3 The authors also importantly point out the need for long-term planning and care in the intentional overdose patient, which in their case meant transfer to an inpatient psychiatric facility. 1 One of the present authors had the misfortune of caring for a patient with oleander toxicity who after aggressive and eventually successful management of multiple arrhythmias and circulatory support sadly died in a later suicide.…”

“…Their patient had sinus tachycardia, malignant ventricular arrhythmias, and hypotension even when not in VT, all resulting from extreme caffeine overdose. 1 Overdose from antiarrhythmic agents is generally familiar to clinical electrophysiologists, and the diagnostic approach and treatment plan are generally straightforward. In approaching a nonantiarrhythmic agent overdose, we need to develop a differential diagnostic plan based on the primary arrhythmia's presenting features and the unique constellation of multiple arrhythmias that can point to a specific agent.…”

“…In this issue of Circulation: Arrhythmia and Electrophysiology, Fabrizio et al, 1 in a refreshing departure from this norm, take us to a more classic medical teaching rounds relevant to rhythm management. They present a patient with multiple changing malignant rhythm disorders resulting from caffeine toxicity.…”

A case of ventricular tachycardia precipitated by caffeine: a rare occurrence

“…Literature contains a range of patient-tailored treatment strategies. 3 However, management of VT and premature heartbeat should involve assessment of hemodynamic status and associated etiology. If the patient is hemodynamically unstable, hemodialysis can assist in removal of caffeine from the plasma, reduce rhythm discordance and morbidity as observed in several cases.…”

“…2 However, recent clinical studies have not been able to indicate harmful effects such as arrhythmia. 1,3,4 In fact, some have even concluded beneficial properties of caffeine 1 . Caffeine has been considered safe in moderate amounts of ≤400 mg daily intake in healthy adults and a lethal compound capable of inducing considerable toxicity when consumed excessively.…”