Document Detail


Emotional and physical precipitants of ventricular arrhythmia.
MedLine Citation:
PMID:  12356633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Observational studies have suggested that psychological stress increases the incidence of sudden cardiac death. Whether emotional or physical stressors can trigger spontaneous ventricular arrhythmias in patients at risk has not been systematically evaluated. METHODS AND RESULTS: Patients with implantable cardioverter-defibrillators (ICDs) were given diaries to record levels of defined mood states and physical activity, using a 5-point intensity scale, during 2 periods preceding spontaneously occurring ICD shocks (0 to 15 minutes and 15 minutes to 2 hours) and during control periods 1 week later. ICD-stored electrograms confirmed the rhythm at the time of shock. A total of 107 confirmed ventricular arrhythmias requiring shock were reported by 42 patients (33 men; mean age, 65 years; 78% had coronary artery disease) between August 1996 and September 1999. In the 15 minutes preceding shock, an anger level > or =3 preceded 15% of events compared with 3% of control periods (P<0.04; odds ratio, 1.83; 95% confidence intervals, 1.04 to 3.16) Other mood states (anxiety, worry, sadness, happiness, challenge, feeling in control, or interest) did not differ. Patients were more physically active preceding shock than in control periods. Anger and physical activity were independently associated with the preshock period. CONCLUSIONS: Anger and physical activity can trigger ventricular arrhythmias in patients with ICDs. Future investigations of therapies aimed at blocking a response to these stressors may decrease ventricular arrhythmias and shocks in these patients.
Authors:
Rachel Lampert; Tammy Joska; Matthew M Burg; William P Batsford; Craig A McPherson; Diwakar Jain
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-01     Completed Date:  2002-10-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1800-5     Citation Subset:  AIM; IM    
Affiliation:
Yale University School of Medicine, New Haven, Conn, USA.
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MeSH Terms
Descriptor/Qualifier:
Affect
Aged
Anger
Arrhythmias, Cardiac / etiology*,  physiopathology*,  therapy
Defibrillators, Implantable
Electric Countershock
Emotions* / physiology
Female
Heart Rate
Humans
Male
Physical Exertion
Stress, Psychological / physiopathology*
Tachycardia, Ventricular / etiology,  physiopathology,  therapy
Time Factors
Ventricular Dysfunction / physiopathology*,  therapy
Ventricular Fibrillation / etiology,  physiopathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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