This PRISMA 2020-compliant systematic review evaluated the arrhythmogenic and electrocardiographic effects of caffeine consumption in children and adolescents under 19 years of age, searching PubMed, EMBASE, and Cochrane CENTRAL.
12 studies met inclusion criteria (9 case reports, 1 prospective study, 1 retrospective study, 1 review with unpublished case report), encompassing 39 adolescents aged 13–18 with caffeine-associated arrhythmias or ECG changes. Reported events ranged from sinus tachycardia and PACs/PVCs to SVT, ventricular tachycardia, QTc prolongation, and ST-segment abnormalities.
- Extremely small sample (n=39) dominated by case reports, limiting generalizability. - High risk of publication bias toward severe or unusual presentations. - No dose-response thresholds could be established from the available data.
Clinicians evaluating arrhythmias in adolescents should routinely ask about energy drink, caffeine tablet, and powdered caffeine use. High-dose caffeine sources carry real cardiac risk in this age group and warrant targeted patient and family counseling.
