Summary
Introduction:
This editorial commentary, authored by Dr. Robert a. Kloner, discusses the relationship between marijuana and electronic cigarette use and the occurrence of cardiac arrhythmias. The text also explores the potential mechanisms behind these arrhythmias and the impact of marijuana and electronic cigarette use on cardiac structure and function.
Key Points:
* Marijuana use has increased since its legalization in many states, with an estimated 52 million americans using it by the end of 2022.
* While marijuana has potential medical benefits, including reducing severe nausea and vomiting related to cancer chemotherapy and improving certain types of pain, there are no well-established and clinically accepted benefits on the cardiovascular system.
* a growing body of literature suggests a temporal association between marijuana use and acute myocardial infarction, arrhythmias, stroke, and heart failure, as well as an increase in admissions for cardiac-related symptoms since legalization.
* Several review papers have documented cases of arrhythmias associated with marijuana use, with atrial fibrillation and ventricular fibrillation being the most common types.
* Synthetic cannabinoids have been shown to lower blood pressure, increase P-wave width and amplitude, prolong the qRS interval, decrease T-wave amplitude, and cause ST elevation.
* a study examining the nationwide inpatient sample database during the post-legalization period of 2010-2014 found a 31% increase in hospitalizations for arrhythmias with cannabis use disorders and a 71% increase in in-hospital mortality rate.
* Chronic cannabis use has been associated with only mild increases in heart rate in non-ischemic participants, but both supraventricular and nonsustained ventricular tachycardia are more frequent in subjects with ischemic heart disease.
Main Message:
The text highlights the need for increased awareness among healthcare providers regarding the potential adverse effects of marijuana and electronic cigarette use on the cardiovascular system, particularly in relation to arrhythmias. The author emphasizes the importance of systematic research and education on the effects of marijuana and electronic cigarettes, including basic science and clinical studies that administer standardized preparations of these agents long-term to assess their impact on physiology and pathology. The study by qui et al. provides valuable information on the long-term effects of these toxins on cardiac electrophysiology, structure, and function, emphasizing the need for healthcare providers and the general public to be informed about the potential downsides of these agents.
Citation
Kloner Ra. Marijuana and electronic cigarettes on cardiac arrhythmias. heart rhythm. 2023;20(1):87-88. doi:10.1016/j.hrthm.2022.09.022
