Atrial fibrillation and marijuana smoking

Abstract

Marijuana is the most commonly used illicit drug while its abuse and dependence has an increasing prevalence among the young population. Marijuana smoking affects the circulatory system triggering various cardiovascular events. Of note, recent case reports indicate a possible association with atrial fibrillation (AF). In this article, we provide a brief systematic review of all reported cases implicating marijuana smoking in AF development and we concisely discuss the potential underlying mechanisms as well as the clinical implications of this emerging association.

Drug Abuse-Induced Cardiac Arrhythmias: Mechanisms and Management

“…No patient had a structural heart disease, and only one had a precipitating factor (hypertension); all patients had a favorable outcome with no recurrence after cessation of marijuana smoking [42]. Of note, adrenergic stimulation and disturbances in atrial coronary or microvascular flow associated with marijuana smoking may facilitate AF development and perpetuation possibly because of increased pulmonary vein ectopy, enhanced atrial electrical remodeling, and increased dispersion of refractoriness [42]. It should also be stressed that although this adverse event seems to be quite "benign" in young healthy subjects, it is apparently more "malignant" in older patients having other risk factors for thromboembolism.…”

“…In all instances, AF was of recent onset occurring shortly after marijuana smoking in young subjects. No patient had a structural heart disease, and only one had a precipitating factor (hypertension); all patients had a favorable outcome with no recurrence after cessation of marijuana smoking [42]. Of note, adrenergic stimulation and disturbances in atrial coronary or microvascular flow associated with marijuana smoking may facilitate AF development and perpetuation possibly because of increased pulmonary vein ectopy, enhanced atrial electrical remodeling, and increased dispersion of refractoriness [42].…”

Przypadkowo wykryte napadowe migotanie przedsionków

“…Czynniki ryzyka izolowanego AF występującego poniżej 60. roku życia są słabiej udokumentowane. Rozważano wpływ używek (alkoholu, marihuany, palenia tytoniu), masy ciała, cech osobowości, aktywności fizycznej [2][3][4][5]. Żadnego z powyższych czynników ryzyka nie stwierdzono u opisywanego pacjenta.…”

Marijuana Induced Type I Brugada Pattern: A Case Report

“…Common cardiac manifestations of marijuana use include a dose-dependent tachycardia, hypotension, orthostatic hypotension, and a supine increase in blood pressure [2,3]. Cardiac arrhythmia including atrial fibrillation [4,5,6], atrial flutter [7], II degree AV block [8], ventricular fibrillation [9], ventricular tachycardia [10,11,12], asystole [13,14] have been reported with marijuana use.Despite these recent reports the effect of marijuana and its active components on ion-channels in general, cardiac ion channels in particular is largely lacking. Previous investigators have reported a case of acute marijuana intoxication that presented with Brugada like-ST segment elevation [15,16,17,18].…”