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Minerva Cardioangiologica 2020 May 29

DOI: 10.23736/S0026-4725.20.05124-5


language: English

Evaluation of index of cardiac-electrophysiological balance as arrhythmia predictor in bonsai users

Süleyman C. EFE 1 , Ahmet OZ 1, Saadet GUVEN 1, Incifer KAMBUR 2, Hakan TOPACOGLU 2, Turgut KARABAG 1

1 Department of Cardiology, Istanbul Education and Research Hospital, Istanbul, Turkey; 2 Department of Emergency Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey


BACKGROUND: Synthetic cannabinoids are part of a group of drugs called new psychoactive substances. The increase in substance use among young adults is becoming a major problem in the world. In this study we aimed to investigate the effects of synthetic cannabinoid drugs (BONSAI by in name Turkey) to electrocardiographic (ECG) parameters, in patients who were admitted to emergency service with self-reported usage of bonsai.
METHODS: Seventy-two patients (68 males; mean age 33.8 ± 11.8) with self-reported use of bonsai and 27 (22 males; mean age 37.1 ± 8.7) age and sex-matched healthy control group enrolled the study. ECG parameters and rhythm holter were measurements calculated in both groups.
RESULTS: Groups were age and sex-matched. Glucose, potassium , white blood cell count, heart rate end smoking status was significantly different in patients compared to control group. P wave max time, P wave min. time, P wave dispersion, QT max. time QT dispersion, QT corrected time and iCEB measurements (Index of Cardiac-Electrophysiological Balance) were significatly different in patient group. A multivariate logistic regression analysis was used to determine independent predictors of ≥30 VPB(Ventricular premature beat)/h using parameters found to be associated with ≥30 VPB/h in a univariate analysis (potassium, QT max.time, QTc, QRS time, iCEB).In a multivariate analysis, independent predictors of ≥30 VPB/h were potassium (Odds ratio [OR]: 0.107, 95% CI: 0.024-0.481;P= 0.004) and iCEB (OR: 4.474, 95% CI: 1.752-11.429;P= 0.002). In generalize linear model β-coefficient value of interaction terms between K*iCEB has no ımportant effect on ventricular premature beats.
CONCLUSIONS: If the results are confirmed in further studies, iCEB seems to be a simple, easily measurable and non-invasive marker to predict cannabinoid-induced ventricular arrhythmias

KEY WORDS: Bonsai; Index of cardio-electrophysiological balance; iCEB; Arrhythmia

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