Abstract
Objective: The usage of synthetic cannabinoids (SCs) has increased both in Turkey and all worldwide. Here, we evaluate if SCs cause ventricular repolarization abnormalities using initial and after 12th-hour electrocardiograms in patients with acute intoxication of SCs. We examined changes in the QTc and cTp-e parameters to demonstrate ventricular repolarization effects of the usage of SCs. Material and Methods: We used a prospective study design. Twenty patients were included who visited the emergency department, complaining of clouding of consciousness after using SCs. The QT, QTc and Tp-e intervals and several other electrocardiographic parameters were measured at baseline and 12 hours after the usage of SCs. Results: The QRS duration was significantly decreased (102.1 ± 15.5 ms vs 95.0 ± 10.7 ms; p = 0.022). We noted a significant decrease in cQT measurements at the end of the 12th hour (426.6 ± 47.2 ms vs 390.4 ± 42.9 ms; p = 0.002). Similarly, the Tp-e and cTp-e values decreased significantly when SCs lost its acute effect (93.4 ± 21.1 ms vs 77.4 ± 21.0 ms; p = 0.014, 105.3 ± 28.5 ms vs 88.1 ± 21.5 ms; p = 0.01). Conclusions: The usage of SCs affects ventricular repolarization heterogeneity based on QTc and Tp-e intervals
Highlights
The usage of synthetic cannabinoids (SCs) has increased both in Turkey and all over the world
The usage of synthetic cannabinoids ECGs — electrocardiograms (SCs) affects ventricular repolarization heterogeneity based on QTc and Tp-e intervals
We evaluated whether SCs were responsible for ventricular repolarization abnormalities using initial and 12th-hour electrocardiograms (ECGs) in patients with acute intoxication resulting from SCs
Summary
The usage of synthetic cannabinoids (SCs) has increased both in Turkey and all over the world. Synthetic cannabinoids are psychoactive substances showing similar agonistic effects on SC receptors such as D9-tetrahydrocannabinole (D9-THC), which is the active metabolite of cannabis [1]. It has become more attractive than natural cannabinoid (i.e., marijuana) because they are accessible, cheap and cannot be detected in blood using a routine toxicological examination. Hoyte et al [6] reported that the well-defined side effects of SCs include nausea (in 10% of cases), vomiting (15.3%), tachycardia (40.0%), bradycardia (1.3%), hypertension (8.1%), chest pain (4.7%), anxiety (23.4%), dizziness/lethargy (7.3 %) in a study of 1353 individuals [6]. Studies have demonstrated the inhibitor effects of cannabinoids on myocardial voltage-gated sodium channels and L-type calcium channels independent of sympathetic nervous system effects [7, 8]
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