The Effect of Synthetic Cannabinoids on P-Wave Dispersion: An Observational Study

Abstract

Objective: The aim of this study was to investigate the effect of synthetic cannabinoids (SC) on P-wave dispersion (PD) in patients who consume SC. Materials and Methods: The study population included 72 patients who consumed SC and 36 age- and sex-matched healthy controls. The severity of addiction was detected using the addiction profile index (BAPI). The PD was measured by 12-lead ECG obtained upon admission to hospital. Statistical analyses were performed using the SPSS v20.0 statistical software package. Results: The mean age of the patients and controls was 26.9 ± 7.0 and 26.3 ± 6.5 years, respectively. Mean duration of SC consumption was 1.7 ± 0.7 years. Mean BAPI score of patients who consumed SC was 12.8 ± 3.4. Patients who consumed SC had a significantly higher PD value than controls (37.7 ± 11.5 vs. 30.6 ± 6.4 ms, p < 0.001). The BAPI score was significantly correlated with PD value (r = 0.675, p < 0.001). In the linear regression model that included PD value, age and heart rate, PD value was significantly and independently correlated with BAPI score (r² of the model = 0.339; p < 0.001). Conclusions: In this study, patients who consumed SC had significantly higher PD values than controls, and the BAPI score correlated with the PD value. Hence SC consumption could lead to an increased risk of cardiovascular disease through prolonged PD. We recommend the use of the simple and inexpensive ECG to assess cardiovascular risk in patients who consume SC.

Electrocardiographic alterations in patients consuming synthetic cannabinoids

“…In a recent study published by Aydin Sunbul et al, a significant association between higher PWD and chronic SCB consumption was demonstrated. In their well-defined study, PWD was significantly higher in the patient group consuming SCBs compared to healthy controls and positively correlated with the severity of addiction (Aydin Sunbul et al, 2016). Similarly, increased PWD was also shown in our study.…”

“…There has been a growing interest to the cardiovascular effects of SCBs due to the fact that many young patients consuming SCBs involve the emergency services because of the side effects of the substance (Aydin Sunbul et al, 2016). However, the exact mechanism underlying the cardiovascular side effects of SCBs is not well defined.…”

“…In contrast, higher doses of delta-9-THC may reflect increased parasympathetic activity, which causes hypotension and bradycardia. However, the absence of arrhythmia may not be enough to exclude cardiovascular side effects of the substance (Aydin Sunbul et al, 2016). In this context, we can speculate that altered autonomic nervous system control by chronic consumption of SCBs may be a reason for altered atrial propagation parameters.…”

“…Synthetic derivates of cannabis, the famous ones named as “Bonsai”, “Spice”, “K2”, “Happy Tiger Nuke Incense”, “Mojo”, “Banana Cream Nuke”, “Aroma” and “Maya”, have become an important health problem around the world, especially in young adults (Evans-Brown et al, 2015). Their popularity is increasing day by day (Shah et al, 2016) due to their cheap price, easy availability, intense psychoactive effects, and undetectable features in toxicological routine urine drug tests (Aydin Sunbul et al, 2016; Castaneto et al, 2014). There are various types of SCBs and new ones are in progress to be synthesized.…”

“…The exact mechanism causing a cardiovascular event is not known. However, in an observational study published by Aydin Sunbul et al, P wave dispersion (PWD) was shown to be increased in patients consuming SCBs compared to controls and the PWD values were positively correlated with the patient’s addiction severity (Aydin Sunbul et al, 2016). Von Der Haar et al described a patient presenting with corrected QT (QTc) prolongation after SCB abuse in a case report (Von Der Haar et al, 2016).…”