Abstract 14161: Recreational Cannabis Use and the Risk of Atrial Arrhythmias: Evidence From a Meta-Analysis of Observational Studies

Introduction: Tetrahydrocannabinol is known to induce sympathetic stimulation and endothelial dysfunction, potentially increasing the susceptibility to arrhythmias. While a recent AHA consensus document outlined various cardiovascular risks associated with cannabis use, there was a paucity of data linking its use with arrhythmias. Therefore, we sought to investigate the association between recreational cannabis use and the risk of atrial arrhythmias.

Methods: Electronic databases were searched for articles published up to April 2023 for studies that assessed the effect of the recreational use of cannabis on the risk of atrial arrhythmias (atrial fibrillation/flutter, supraventricular tachycardia). The study was prospectively registered (PROSPERO CRD42023428219). Three reviewers independently appraised the data, with summary odds ratios (OR) and 95% confidence intervals (CIs) pooled using a random-effects model.

Results: Our analysis included seventeen cohort studies with a total of 81,269,314 participants from North America, Europe and Oceania. Four studies were prospective observational in design. Mean age was 46 years [41-72] and mean female participation was 45% [31-83] across studies. Recreational use of cannabis was associated with a significantly higher risk of atrial arrhythmias (OR 1.55, 95% CI 1.13-2.13) with high degree of heterogeneity (I2=99%). On meta-regression, mean age was not a contributing factor for the observed effect (p=0.58).

Conclusions: Recreational use of cannabis was associated with 1.5-fold increased risk of atrial arrhythmias. Prospective studies are warranted to further explore this relationship and the public health implications of cannabis utilization.