{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:18Z","timestamp":1787008698593,"version":"build-2736575974"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is an increase in the sale of legal drugs in our country. One of these substances is kratom. Kratom (Mitragyna speciosa) is a partial agonist of the opioid kappa, mu, and delta receptors. It acts as a stimulant at low concentrations, making users feel more energetic and euphoric. It has sedative and antinociceptive effects at higher doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>An 18-year-old man collapsed during football training and required cardiopulmonary resuscitation; the initial rhythm was ventricular fibrillation managed by defibrillation. Laboratory parameters were unremarkable. Blood samples sent for toxicological evaluation were positive for kratom and caffeine. Echocardiographic examination, coronary computed tomography angiography, and cardiac magnetic resonance imaging did not prove the cause. Genetic testing did not find a pathogenic gene variant associated with familial ventricular fibrillation, but a variant of unknown significance was found in MYOM1. Given this situation, we implanted an implantable cardioverter-defibrillator (ICD) from the secondary prevention of sudden cardiac death (SCD) according to the guidelines of the European Society of Cardiology (ESC). No recurrence of ventricular arrhythmia has been reported by ambulatory ICD memory checks on our patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In some country, kratom is freely available and sold as a plant, not a drug. Only incident cases of ventricular fibrillation after kratom use are described in the literature. There is insufficient scientific evidence linking kratom to ventricular fibrillation. This is an absolutely crucial case report of this type, which has not yet been published in similar circumstances in the world. Therefore, the development of ventricular fibrillation was assumed to be due to a combination of kratom, caffeine, and exercise. The safety profile and effects of kratom should be the subject of future research. We would like to stress the importance of reporting further case series for more scientific evidence and thus increasing the pressure for stricter availability and regulation of kratom in some countries, especially where it is over-the-counter.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae364","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T18:46:00Z","timestamp":1721673960000},"source":"Crossref","is-referenced-by-count":1,"title":["Ventricular fibrillation during football training as a consequence of kratom and caffeine use in an adolescent: case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3537-0342","authenticated-orcid":false,"given":"Jozef","family":"Dodul\u00edk","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Cardiology, University Hospital Ostrava , Ostrava , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5183-9557","authenticated-orcid":false,"given":"Ji\u0159\u00ed","family":"Pl\u00e1\u0161ek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, University Hospital Ostrava , Ostrava , Czech Republic"},{"name":"Centre for Research on Internal and Cardiovascular Diseases, Faculty of Medicine, University of Ostrava , Ostrava , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0648-0071","authenticated-orcid":false,"given":"Petr","family":"Handlos","sequence":"additional","affiliation":[{"name":"Institute of Forensic Medicine, University Hospital Ostrava , Ostrava , Czech Republic"},{"name":"Faculty of Medicine, Institute of Forensic Medicine, University of Ostrava, Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"G\u0159ego\u0159ov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, University Hospital Ostrava , Ostrava , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-7442","authenticated-orcid":false,"suffix":"Jr","given":"Jan","family":"V\u00e1clav\u00edk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, University Hospital Ostrava , Ostrava , Czech Republic"},{"name":"Centre for Research on Internal and Cardiovascular Diseases, Faculty of Medicine, University of Ostrava , Ostrava , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"2024081308394163800_ytae364-B1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s40122-020-00151-x","article-title":"Kratom\u2014pharmacology, clinical implications, and outlook: a comprehensive review","volume":"9","author":"Eastlack","year":"2020","journal-title":"Pain Ther"},{"key":"2024081308394163800_ytae364-B2","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/15563650701241795","article-title":"Opioid receptors and legal highs: Salvia divinorum and kratom","volume":"46","author":"Babu","year":"2008","journal-title":"Clin Toxicol"},{"key":"2024081308394163800_ytae364-B3","doi-asserted-by":"crossref","first-page":"e115648","DOI":"10.1371\/journal.pone.0115648","article-title":"Evaluation of the cardiotoxicity of mitragynine and its analogues using human induced pluripotent stem cell-derived cardiomyocytes. 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