Bidirectional ventricular tachycardia induced by caffeine poisoning
Nozomi Toya1, Shutaro Isokawa1, Akiyoshi Suzuki1
1Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
Bidirectional ventricular tachycardia (BVT), a rare arrhythmia, was observed following massive caffeine overdose. Hemodialysis effectively treated this caffeine-induced BVT, demonstrating a novel therapeutic approach for this specific poisoning.
Area of Science:
- Cardiology
- Toxicology
- Electrophysiology
Background:
- Bidirectional ventricular tachycardia (BVT) is an electrocardiography (ECG) finding typically associated with digitalis or aconitine poisoning.
- Caffeine overdose is not previously reported to cause BVT.
Observation:
- A 27-year-old woman presented with cardiac arrest after ingesting a large dose of a caffeine supplement.
- Following resuscitation, she developed BVT, with blood caffeine levels of 232 μg/mL.
Findings:
- The patient's BVT resolved after hemodialysis, which removed the caffeine from her blood.
- A proposed mechanism involves caffeine-induced calcium release, leading to delayed afterdepolarizations and triggered activity in the His-Purkinje system, causing BVT.
Implications:
- This case suggests caffeine poisoning is a potential cause of BVT.
- Hemodialysis is an effective treatment for BVT induced by caffeine toxicity, aiding hemodynamic stabilization.
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