{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:39:14Z","timestamp":1791884354227,"version":"4.3.4"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Beyond their effect on blood pressure, the effect of energy drinks on heart rate in children and teenagers has not been evaluated until now. Thus, this study aimed to investigate the acute cardiovascular effects of energy drinks in healthy children and teenagers. Twenty-six children and adolescents (mean age 14.49 years) received a commercially available energy drink (ED) and placebo on two consecutive days based on the maximum caffeine dosage as proposed by the European Food Safety Authority. Heart rhythm and electrocardiographic time intervals were assessed in a prospective, randomized, double-blind, placebo-controlled, crossover clinical study design. ED consumption resulted in a significantly increased number of supraventricular extrasystoles (SVES) compared to the placebo, whereas supraventricular tachycardia or malignant ventricular arrhythmias were not observed. The mean heart rate (HR) was significantly lower following consumption of EDs. In contrast, QTc intervals were not affected by EDs. Being the first of its kind, this trial demonstrates the cardiovascular and rhythmological effects of EDs in minors. Interestingly, EDs were associated with adverse effects on heart rhythm. Whether higher dosages or consumption in children with preexisting conditions may cause potentially harmful disorders was beyond the scope of this pilot study and remains to be determined in future trials. Trial Registration Number (DRKS-ID): DRKS00027580.<\/jats:p>","DOI":"10.3390\/cells11030498","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T09:59:21Z","timestamp":1643709561000},"page":"498","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Energy Drinks and Their Acute Effects on Heart Rhythm and Electrocardiographic Time Intervals in Healthy Children and Teenagers: A Randomized Trial"],"prefix":"10.3390","volume":"11","author":[{"given":"Guido","family":"Mandilaras","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Hospital of the University of Munich, Ludwig Maximilians University Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengzhu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Hospital of the University of Munich, Ludwig Maximilians University Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Dalla-Pozza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Hospital of the University of Munich, Ludwig Maximilians University Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus Alexander","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Hospital of the University of Munich, Ludwig Maximilians University Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix Sebastian","family":"Oberhoffer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Hospital of the University of Munich, Ludwig Maximilians University Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"key":"ref_1","unstructured":"Insights, I.M. (Nutritional Outlook, 2018). Energy Drink Sales Still on the Rise, Despite Slowdown in Innovation, Nutritional Outlook."},{"key":"ref_2","first-page":"394E","article-title":"Gathering Consumption Data on Specific Consumer Groups of Energy Drinks","volume":"10","author":"Zucconi","year":"2013","journal-title":"EFSA Support. Publ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.addbeh.2014.11.023","article-title":"Alcohol and Energy Drink Use among Adolescents Seeking Emergency Department Care","volume":"43","author":"Bonar","year":"2015","journal-title":"Addict. Behav."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"557","DOI":"10.3389\/fcvm.2021.679105","article-title":"Energy Drink-Associated Electrophysiological and Ischemic Abnormalities: A Narrative Review","volume":"8","author":"Cao","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1177\/1060028016656433","article-title":"Impact of Acute Energy Drink Consumption on Blood Pressure Parameters: A Meta-Analysis","volume":"50","author":"Shah","year":"2016","journal-title":"Ann. Pharmacother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e004448","DOI":"10.1161\/JAHA.116.004448","article-title":"Randomized Controlled Trial of High-Volume Energy Drink Versus Caffeine Consumption on ECG and Hemodynamic Parameters","volume":"6","author":"Fletcher","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e011318","DOI":"10.1161\/JAHA.118.011318","article-title":"Impact of High Volume Energy Drink Consumption on Electrocardiographic and Blood Pressure Parameters: A Randomized Trial","volume":"8","author":"Shah","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jce.12504","article-title":"A Prospective Placebo Controlled Randomized Study of Caffeine in Patients with Supraventricular Tachycardia Undergoing Electrophysiologic Testing","volume":"26","author":"Lemery","year":"2015","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_9","first-page":"505","article-title":"Energy drinks and arterial stiffness in healthy children","volume":"50","author":"Li","year":"2021","journal-title":"Nieren-Hochdruckkrankheiten"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s001120170107","article-title":"Perzentile f\u00fcr den body-mass-index f\u00fcr das Kindes-und jugendalter unter heranziehung verschiedener deutscher stichproben","volume":"149","author":"Wabitsch","year":"2001","journal-title":"Mon. Kinderheilkd."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2015). Scientific Opinion on the Safety of Caffeine. EFSA J., 13, 4102.","DOI":"10.2903\/j.efsa.2015.4102"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.jacc.2007.01.024","article-title":"Recommendations for the Standardization and Interpretation of the Electrocardiogram","volume":"49","author":"Kligfield","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1542-474X.1997.tb00325.x","article-title":"An Analysis of the Time-Relations of Electrocardiograms","volume":"2","author":"Bazett","year":"1997","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lindinger, A., and Paul, T. (2016). EKG Im Kindes-Und Jugendalter: EKG-Basisinformationen-Herzrhythmusst\u00f6rungen-Angeborene Herzfehler Im Kindes-, Jugend-Und Erwachsenenalter, Georg Thieme Verlag.","DOI":"10.1055\/b-003-128227"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1542\/peds.2011-0965","article-title":"Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate?","volume":"127","author":"Schneider","year":"2011","journal-title":"Pediatrics"},{"key":"ref_16","first-page":"1015","article-title":"Hearing Raises Questions on Energy Drink Marketing","volume":"310","author":"Mitka","year":"2013","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s10840-019-00610-2","article-title":"European Cardiac Arrhythmia Society Statement on the Cardiovascular Events Associated with the Use or Abuse of Energy Drinks","volume":"56","author":"Santini","year":"2019","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1093\/ajcn\/81.3.578","article-title":"Caffeine and Risk of Atrial Fibrillation or Flutter: The Danish Diet, Cancer, and Health Study","volume":"81","author":"Frost","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_19","first-page":"257","article-title":"Effect of Caffeine on Ventricular Arrhythmia: A Systematic Review and Meta-Analysis of Experimental and Clinical Studies","volume":"18","author":"Zuchinali","year":"2016","journal-title":"EP Eur."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.amjcard.2013.08.058","article-title":"Review of Published Cases of Adverse Cardiovascular Events After Ingestion of Energy Drinks","volume":"113","author":"Goldfarb","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1016\/j.amjcard.2015.09.025","article-title":"Frequent Atrial Premature Complexes and Their Association With Risk of Atrial Fibrillation","volume":"116","author":"Acharya","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1055\/s-0038-1629316","article-title":"Die Extrasystolie","volume":"13","author":"Marx","year":"2013","journal-title":"Kinder-Jugendmed."},{"key":"ref_23","first-page":"208","article-title":"Supraventrikul\u00e4re und ventrikul\u00e4re Extrasystolen","volume":"17","author":"Staeger","year":"2017","journal-title":"Swiss Med. Forum"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1345\/aph.1L614","article-title":"Effect of \u201cEnergy Drink\u201d Consumption on Hemodynamic and Electrocardiographic Parameters in Healthy Young Adults","volume":"43","author":"Steinke","year":"2009","journal-title":"Ann. Pharmacother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jelectrocard.2018.07.025","article-title":"Cardiovascular Responses to ENERGY Drinks in a Healthy Population during EXercise: The C-Energy-X Study","volume":"51","author":"Kozik","year":"2018","journal-title":"J. Electrocardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"635","DOI":"10.3389\/fphys.2019.00635","article-title":"Errors of Fixed QT Heart Rate Corrections Used in the Assessment of Drug-Induced QTc Changes","volume":"10","author":"Hnatkova","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"H1798","DOI":"10.1152\/ajpheart.00577.2013","article-title":"QT\/RR Curvatures in Healthy Subjects: Sex Differences and Covariates","volume":"305","author":"Malik","year":"2013","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1038\/bjp.2008.123","article-title":"The Impact of Varying Autonomic States on the Dynamic Beat-to-Beat QT\u2013RR and QT\u2013TQ Interval Relationships","volume":"154","author":"Fossa","year":"2008","journal-title":"Br. J. Pharmacol."}],"container-title":["Cells"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4409\/11\/3\/498\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:12:10Z","timestamp":1760134330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4409\/11\/3\/498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,31]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["cells11030498"],"URL":"https:\/\/doi.org\/10.3390\/cells11030498","relation":{},"ISSN":["2073-4409"],"issn-type":[{"value":"2073-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,31]]}}}