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The effect of long-term use of methylphenidate on cardiac autonomic functions and ventricular arrhythmogenesis: a prospective case–control study

Published online by Cambridge University Press:  04 May 2023

Rahmi Ozdemir ,
Yaşar Tanır ,
Batuhan Berk Demir ,
Seheryeli Yılmaz ,
Damla Geçkalan Soysal Open the ORCID record for Damla Geçkalan Soysal [Opens in a new window]  and
Cem Karadeniz Open the ORCID record for Cem Karadeniz [Opens in a new window]
Rahmi Ozdemir
Affiliation:
Pediatric Cardiology, Kütahya Health Sciences University, Kutahya, Turkey
Yaşar Tanır
Affiliation:
Child and Adolescent Psychiatry, Kütahya Health Sciences University, Kutahya, Turkey
Batuhan Berk Demir
Affiliation:
Pediatrics, Kütahya Health Sciences University, Kutahya, Turkey
Seheryeli Yılmaz
Affiliation:
Child and Adolescent Psychiatry, Kütahya Health Sciences University, Kutahya, Turkey
Damla Geçkalan Soysal
Affiliation:
Pediatrics, Kütahya Health Sciences University, Kutahya, Turkey
Cem Karadeniz*
Affiliation:
Department of Pediatric Cardiology, School of Medicine, Katip Celebi University, Izmir, Turkey
*
Corresponding author: Dr C. Karadeniz, Pediatric Cardiology, Kütahya Health Sciences University, Kutahya, Turkey. Email: karadenizcem@yahoo.com
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Abstract

Objective:

We aimed to assess cardiac autonomic balance with heart rate variability by using 24-hour Holter electrocardiography and also to assess susceptibility to ventricular arrhythmias by using microvolt T wave alternance in children with attention deficit hyperactivity disorder.

Method:

This study was conducted with age- and gender-matched groups of 40 patients taking long-acting methylphenidate for more than a year and 55 healthy controls. Heart rate variability analysis for cardiac autonomic functions and microvolt T wave alternance measurements for susceptibility to ventricular arrhythmias were evaluated by 24-hour Holter electrocardiography.

Results:

The mean age 10.9 ± 2.7 years, mean duration of therapy 22.76 months, and mean methylphenidate doses were 37.64 mg/day. The study group had considerably higher rMSSD, higher HF, and a lower LF/HF ratio (respectively, p : 0.02, p : 0.001 and p : 0.01). While parasympathetic activity parameters were elevated, sympathetic activity parameters were low during the sleep period. Increase in the microvolt T wave alternance values of the study group was not found to be statistically significant (p > 0.05).

Conclusion:

In children taking long-acting methylphenidate, the autonomic balance was shown to be in favour of the parasympathetic system. Determination of the vulnerability to life-threatening ventricular arrhythmias has been evaluated for the first time in children with attention deficit hyperactivity disorder. Accordingly, microvolt T-wave alternance values give the notion that drug use is safe.

Keywords

Attention deficit hyperactivity disordermethylphenidateheart rate variabilitymicrovolt T wave alternance24-hour Holter electrocardiogram
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 1 , January 2024 , pp. 32 - 36
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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