High levels of energy drinks used by young people to improve sports performance are proarrhythmic

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1 Cardiostim EHRA Europace 2016, Nice - June 8-11, 2016 High levels of energy drinks used by young people to improve sports performance are proarrhythmic Antonio Raviele, MD, FESC, FHRS President ALFA -Alliance to Fight Atrial fibrillation- Venezia

2 Energy Drinks Are beverages that contain substances that act as nonnutritive stimulants, and are marketed to improve energy, endurance, athletic performance, weight loss, mental concentration and allertness, and to relieve fatigue. They are distinct from sports drinks and vitamin waters

3 Sport Drinks Are beverages that contain carbohydrates, minerals, electrolytes, and flavoring, and are marketed to rehydrate the body and to replace carbohydrates and electrolytes lost during intense exercise.

4 Vitamin Waters Are beverages that contain water, vitamins, nutrients, and sometimes sweeteners, and are marketed to improve endurance, to enhance relaxation, and to strengthen immune defense

5 Energy Drinks Have become very popular with nearly 200 brands available in >140 countries. They represent a rapidly expanding segment of the beverage market, accounting for roughly $27 billion in 2013 all over the world. Half of the energy drinks market consists of children, adolescents, and young adults. By self-report, 30-50% of old teens consume energy drinks regularly, and 41% consume them before sport activity.

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7 Dufendach KA et al. Heart Rhythm 2012; 9:

8 Dufendach KA et al. Heart Rhythm 2012; 9:

9 Energy Drinks Energy drinks are usually highly caffeineited beverages and this peculiarity, toghether with the presence of other stimulants, exposes consumers at some risk of caffein toxicity and other serious adverse health events.

10 Caffeine Caffeine is an adenosine and benzodiazepine receptor antagonist, phosphodiesterase inhibitor, and central nervous system stimulant. Physiologically caffeine increases heart rate, blood pressure, speech rate, motor activity, attentiveness, mood, gastric secretion, diuresis, and temperature

11 Caffeine Adults who consume low-to-moderate amounts of caffeine (1-3 mg/kg) have improved exercise endurance, cognition, reaction time, and mood with sleep deprivation Consuming 4 to 12 mg/kg of caffeine has been associated with undesirable symptoms, including anxiety and jitteriness. Headache, and fatigue, common withdrawal symptoms, can occurr after short-term high-dose use.

12 Caffeine intoxication Is due to idiosyncratic or excessive dosage and is characterized by nervousness, irritability, anxiety, insommia, tremor, palpitations, and upset stomach. Additional adverse events include vomiting and abdominal pain, hypokalemia, rigidity, altered consciousness, paralysis, hallucinations, seizures, rhabdomyolisis, supraventricular and ventricular arrhythmias, and death.

13 Am J Med 2011; 124:

14 Heart 2013; 99:

15 Europace 2016;18:

16 Caffeine intoxication However, at very high caffeine doses, such as those observed after overconsumption of energy drinks in adolescents and young adults, the risk of cardiac arrhythmias is not negligible.

17 Am J Cardiol 2014; 113:

18 Ventr SupraV Goldfarb M et al. Am J Cardiol 2014; 113:

19 J Med Case Rep 2011; 5: 18

20 Di Rocco JP et al. J Med Case Rep 2011; 5: 18

21 Di Rocco JP et al. J Med Case Rep 2011; 5: 18

22 Di Rocco JP et al. J Med Case Rep 2011; 5: 18

23 An Ped 2012;

24 Izquierdo Fos I et al. An Ped 2012;

25 Izquierdo Fos I et al. An Ped 2012;

26

27 J Med Case Rep 2011; 5: 18

28 Berger AJ et al. J Med Case Rep 2011; 5: 18

29 Berger AJ et al. J Med Case Rep 2011; 5: 18

30 Berger AJ et al. J Med Case Rep 2011; 5: 18

31 Berger AJ et al. J Med Case Rep 2011; 5: 18

32 Berger AJ et al. J Med Case Rep 2011; 5: 18

33 Higgins JP et al. Beverages 2015; 1:

34 Higgins JP et al. Beverages 2015; 1:

35 Sanchis-Gomar F et al. Can J Cardiol 2015; 31: