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The Effect of Caffeine on Ventricular Ectopic Activity in Patients With Malignant Ventricular Arrhythmia

The Effect of Caffeine on Ventricular Ectopic Activity in Patients With Malignant Ventricular... Abstract • We evaluated the effect of caffeine on ventricular ectopic activity in a group of 50 consecutive patients with malignant ventricular arrhythmia. The clinical arrhythmia in these patients (mean age, 61 years) was recurrent ventricular tachycardia in 21 (42%), ventricular fibrillation in three (6%), and symptomatic nonsustained ventricular tachycardia in 26 (52%). Forty-two (84%) had either ischemic heart disease or cardiomyopathy. Each patient underwent two short-term drug trials on successive days, receiving either decaffeinated coffee mixed with 200 mg of caffeine or the decaffeinated drink alone. Continuous electrocardiographic recordings were made during the 30-minute control period, the three-hour observation period, and the hourly bicycle exercise tests. Forty-five patients (90%) exhibited ventricular couplets and 29 patients (58%) had salvos of ventricular tachycardia during the testing. However, no differences between the caffeine and decaffeinated trials were observed in either individual or group data on total or repetitive ventricular arrhythmia. Serum catecholamine levels reflected the average increase in serum caffeine level but were not associated with enhanced arrhythmia. We found no evidence that a modest dose of caffeine is arrhythmogenic, even among patients with known life-threatening arrhythmia. (Arch Intern Med 1989;149:637-639 References 1. Sutherland DJ, McPherson DD, Rentin KW, et al: The effect of caffeine on cardiac rate, rhythm and ventricular repolarization . Chest 1985;87:319-324.Crossref 2. Lacroix AZ, Mead LA, Liang KY, et al: Coffee consumption and the incidence of coronary heart disease . N Engl J Med 1986;315:977-982.Crossref 3. Piters KM, Colombo A, Olson HG, et al: Effect of coffee and exercise induced angina pectoris due to coronary artery disease in habitual coffee drinkers . Am J Cardiol 1985;55:277-280.Crossref 4. Whitsett TL, Manion CV, Christensen HD: Cardiovascular effects of coffee and caffeine . Am J Cardiol 1984;53:918-922.Crossref 5. Dobmeyer DJ, Stine RA, Leier CV, et al: The arrhythmogenic effects of caffeine in human beings . N Engl J Med 1983;308:814-816.Crossref 6. Graboys TB, Lown B: Coffee, arrhythmias and common sense . N Engl J Med 1983;308:835-837.Crossref 7. Graboys TB, Lown B, Podrid PJ, et al: Survival of patients with malignant ventricular arrhythmia treated with antiarrhythmic agents . Am J Cardiol 1982;50:437-443.Crossref 8. Podrid PJ, Lown B, Graboys TB, et al: Use of short-term drug testing as part of the systematic approach for evaluation of antiarrhythmic drugs . Circulation 1986;73( (suppl 2) ):81-91. 9. Jelinek M, Lown B: Exercise stress testing for exposure and cardiac arrhythmia . Prog Cardiovasc Dis 1974;16:497-504.Crossref 10. Young DZ, Lampert S, Graboys TB, et al: Safety of maximal exercise testing in patients at high risk for ventricular arrhythmia . Circulation 1984;70:184-191.Crossref 11. Orcutt JJ, Kozak PP Jr, Gilman SA, et al: Micro-scale method for theophylline in body fluids by reversed, high pressure liquid chromatography . Clin Chem 1977;23:599-601. 12. Blanchard J, Mohammadi JD, Conrad KA: Improved liquid-chromatographic determination of caffeine in plasma . Clin Chem 1980;26:1351-1354. 13. Lown B, Verrier RL: Neural and psychological factors and the occurrence of ventricular fibrillation , in Riemersma RA, Oliver MF (eds): Catecholamines in the Non-Ischaemic and Ischaemic Myocardium . Amsterdam, Elsevier/North-Holland Biomedical Press, 1982, pp 179-201. 14. Gould L, Venkataraman K, Goswami M, et al: The cardiac effects of coffee . Angiology 1973;24:455-463.Crossref 15. DeBacker G, Jacobs D, Prinious R, et al: Ventricular premature contractions: A randomized non-drug intervention trial on normal men . Circulation 1979;59:762-769.Crossref 16. Robertson D, Wade D, Worlsman R, et al: Tolerance to the humoral and hemodynamic effects of caffeine . J Clin Invest 1981;67:111-117. 17. Myers MG, Harris L, Leenen FH, et al: Caffeine as a possible cause of ventricular arrhythmias during the healing phase of acute myocardial infarction . Am J Cardiol 1987;59:1024-1028.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Effect of Caffeine on Ventricular Ectopic Activity in Patients With Malignant Ventricular Arrhythmia

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1989.00390030105020
Publisher site
See Article on Publisher Site

Abstract

Abstract • We evaluated the effect of caffeine on ventricular ectopic activity in a group of 50 consecutive patients with malignant ventricular arrhythmia. The clinical arrhythmia in these patients (mean age, 61 years) was recurrent ventricular tachycardia in 21 (42%), ventricular fibrillation in three (6%), and symptomatic nonsustained ventricular tachycardia in 26 (52%). Forty-two (84%) had either ischemic heart disease or cardiomyopathy. Each patient underwent two short-term drug trials on successive days, receiving either decaffeinated coffee mixed with 200 mg of caffeine or the decaffeinated drink alone. Continuous electrocardiographic recordings were made during the 30-minute control period, the three-hour observation period, and the hourly bicycle exercise tests. Forty-five patients (90%) exhibited ventricular couplets and 29 patients (58%) had salvos of ventricular tachycardia during the testing. However, no differences between the caffeine and decaffeinated trials were observed in either individual or group data on total or repetitive ventricular arrhythmia. Serum catecholamine levels reflected the average increase in serum caffeine level but were not associated with enhanced arrhythmia. We found no evidence that a modest dose of caffeine is arrhythmogenic, even among patients with known life-threatening arrhythmia. (Arch Intern Med 1989;149:637-639 References 1. Sutherland DJ, McPherson DD, Rentin KW, et al: The effect of caffeine on cardiac rate, rhythm and ventricular repolarization . Chest 1985;87:319-324.Crossref 2. Lacroix AZ, Mead LA, Liang KY, et al: Coffee consumption and the incidence of coronary heart disease . N Engl J Med 1986;315:977-982.Crossref 3. Piters KM, Colombo A, Olson HG, et al: Effect of coffee and exercise induced angina pectoris due to coronary artery disease in habitual coffee drinkers . Am J Cardiol 1985;55:277-280.Crossref 4. Whitsett TL, Manion CV, Christensen HD: Cardiovascular effects of coffee and caffeine . Am J Cardiol 1984;53:918-922.Crossref 5. Dobmeyer DJ, Stine RA, Leier CV, et al: The arrhythmogenic effects of caffeine in human beings . N Engl J Med 1983;308:814-816.Crossref 6. Graboys TB, Lown B: Coffee, arrhythmias and common sense . N Engl J Med 1983;308:835-837.Crossref 7. Graboys TB, Lown B, Podrid PJ, et al: Survival of patients with malignant ventricular arrhythmia treated with antiarrhythmic agents . Am J Cardiol 1982;50:437-443.Crossref 8. Podrid PJ, Lown B, Graboys TB, et al: Use of short-term drug testing as part of the systematic approach for evaluation of antiarrhythmic drugs . Circulation 1986;73( (suppl 2) ):81-91. 9. Jelinek M, Lown B: Exercise stress testing for exposure and cardiac arrhythmia . Prog Cardiovasc Dis 1974;16:497-504.Crossref 10. Young DZ, Lampert S, Graboys TB, et al: Safety of maximal exercise testing in patients at high risk for ventricular arrhythmia . Circulation 1984;70:184-191.Crossref 11. Orcutt JJ, Kozak PP Jr, Gilman SA, et al: Micro-scale method for theophylline in body fluids by reversed, high pressure liquid chromatography . Clin Chem 1977;23:599-601. 12. Blanchard J, Mohammadi JD, Conrad KA: Improved liquid-chromatographic determination of caffeine in plasma . Clin Chem 1980;26:1351-1354. 13. Lown B, Verrier RL: Neural and psychological factors and the occurrence of ventricular fibrillation , in Riemersma RA, Oliver MF (eds): Catecholamines in the Non-Ischaemic and Ischaemic Myocardium . Amsterdam, Elsevier/North-Holland Biomedical Press, 1982, pp 179-201. 14. Gould L, Venkataraman K, Goswami M, et al: The cardiac effects of coffee . Angiology 1973;24:455-463.Crossref 15. DeBacker G, Jacobs D, Prinious R, et al: Ventricular premature contractions: A randomized non-drug intervention trial on normal men . Circulation 1979;59:762-769.Crossref 16. Robertson D, Wade D, Worlsman R, et al: Tolerance to the humoral and hemodynamic effects of caffeine . J Clin Invest 1981;67:111-117. 17. Myers MG, Harris L, Leenen FH, et al: Caffeine as a possible cause of ventricular arrhythmias during the healing phase of acute myocardial infarction . Am J Cardiol 1987;59:1024-1028.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1989

References

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