Refractory ventricular fibrillation caused by caffeine intoxication

Area of Science:

• Cardiology
• Toxicology
• Pharmacology

Background:

• Caffeine is a widely consumed stimulant with known cardiac effects.
• Lethal cardiac events from caffeine intoxication are reported, but pure caffeine poisoning cases are rare.
• The precise proarrhythmic mechanisms of caffeine are not fully elucidated.

Observation:

• A 30-year-old female presented with incessant ventricular fibrillation (VF) after ingesting 12g of caffeine tablets.
• The VF was refractory to repeated defibrillation attempts.
• Therapeutic hypothermia and percutaneous cardiopulmonary support were initiated.

Findings:

• Extremely high serum caffeine concentration (172 mg/L) was detected.
• The patient achieved full recovery after 16 days of hospitalization.
• This case underscores the potentially lethal arrhythmogenic nature of caffeine.

Implications:

• Intensive management strategies are crucial for patients with severe caffeine intoxication.
• Further research into caffeine's pharmacological actions and proarrhythmic effects is warranted.
• Clinicians should consider caffeine toxicity in patients presenting with refractory arrhythmias.