A prospective, randomized crossover trial (MARY-JANE; NCT06021613) assessed the acute effects of inhaled cannabis vs. abstinence on cardiac ectopy, mean glucose, step counts, and sleep duration in 108 habitual cannabis users over 14 days.
Randomization to inhaled cannabis was linked to a **9% reduction in total ectopic beats** (RR: 0.91; 95% CI: 0.85–0.98; P=0.02), driven by a **10% drop in premature atrial contractions** (RR: 0.90; 95% CI: 0.82–0.97; P=0.012); premature ventricular contractions, step counts, sleep duration, and glucose levels showed no significant change.
- Adherence to randomization was imperfect, limiting causal inference. - Withdrawal effects in the abstinence arm may confound the ectopy reduction seen with cannabis use. - Co-interventions (e.g., concurrent substance use) could not be fully excluded.
Clinicians should interpret this finding cautiously — the observed reduction in ectopy may reflect cannabis withdrawal in the abstinence arm rather than a direct cardiac benefit of cannabis. This trial does not support recommending cannabis for arrhythmia management.
