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


Ozdemir R., Tanır Y., Demir B. B., Yılmaz S., Geçkalan Soysal D., Karadeniz C.

Cardiology in the young, vol.34, no.1, pp.32-36, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 34 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.1017/s1047951123001038
  • Journal Name: Cardiology in the young
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.32-36
  • Keywords: 24-hour Holter electrocardiogram, Attention deficit hyperactivity disorder, heart rate variability, methylphenidate, microvolt T wave alternance
  • Kütahya Health Sciences University Affiliated: Yes

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.