Energy Drinks and Arrhythmias in Adolescents and Young Adults: A Narrative Review of the Last Decade

Abstract

Abstract

Background and Objectives: Energy drinks (EDs), widely consumed by adolescents and young adults, contain caffeine and other stimulants marketed to enhance energy and performance. ED consumption has been associated with adverse cardiovascular effects, although most evidence derives from adult populations. This review examines the association between ED intake and arrhythmias or electrocardiographic (ECG) alterations in young people, including the influence of consumption patterns and the reversibility of reported changes. Materials and Methods: A review of the literature of the last ten years was conducted in the PubMed, Scopus, Cochrane Library and Google Scholar databases, using various combinations of the key words: “Energy Drinks”, “arrhythmias”, “ECG”, “electrocardiogram”, “dysrhythmias”, “children”, “teen”, “teenagers”, “adolescents”, “young adults, “young people”. Results: 22 studies met the inclusion criteria: 10 RCTs, 5 non RCTs, 1 observational study and 6 case reports. Evidence suggests that ED consumption may be associated with cardiac rhythm disturbances and ECG alterations in young individuals. Reported events include atrial fibrillation, ventricular fibrillation, and, in rare cases, cardiac arrest, often following moderate-to-high ED intake. Experimental studies have demonstrated acute cardiovascular effects, including QTc interval changes (6–20 ms), increased supraventricular ectopic activity, alterations in heart rate (3–10 bpm) and ST–T changes. Most reported alterations appeared acute and reversible; however, their occurrence may be influenced by ED dose, composition, caffeine exposure, and individual susceptibility. Conclusions: ED consumption among adolescents and young adults may increase the risk of arrhythmias. There is consistent evidence across studies showing that the most common effects are HR and QTc alterations, with the composition and quantity of the drinks likely influencing these effects. Important gaps remain regarding frequent consumption, long-term outcomes, the contribution of less-studied ingredients, and the impact on younger populations. Stronger regulations may also be warranted to protect young consumers, particularly those at increased cardiovascular risk.