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Cardiac repolarization instability during psychological stress in patients with ventricular arrhythmias
Open accessAbstract
Introduction Changes in the autonomic nervous system activity are a major trigger of life-threatening ventricular tachyarrhythmias (VTAs). Mental arithmetic, a condition administered in a laboratory setting, can provide insight into the autonomic nervous system activity effects on cardiac physiology. We examined the responses of cardiac repolarization to laboratory-induced psychological stressors in patients with implantable cardioverter-defibrillators (ICDs) with the objective of identifying the indices that differentiate patients with and without subsequent VTA in follow-up. Methods Continuous electrocardiographic signals were recorded using 3 standard bipolar (Holter) leads in 56 patients (age, 63.6 ± 11.9; female, 12%; left ventricular ejection fraction, 32.3 ± 11) with ICDs during mental arithmetic. The patients were separated into those with subsequent VTA during 3 to 4 years of follow-up (group 1: n = 9) and those without VTA (group 2: n = 47). Changes in repolarization (QT interval, mean T wave amplitude [Tamp], and T wave area) were analyzed during 5 minutes at baseline, stress, and recovery. The temporal instability of Tamp and T wave area was examined using the range (Δ) and variance (σ(2)) of beat-to-beat variations of the corresponding parameters. Results There were no significant differences in heart rate between the 2 groups at baseline (61 vs 63 beats per minute, P = .97), stress (64 vs 65 beats per minute, P = .40), and recovery (62 vs 61 beats per minute, P = .88). However, during mental stress and poststress recovery, ΔTamp was almost 2-fold greater in group 1 compared with group 2 (111 [57-203] vs 68 [44-94] μV, P = .04, respectively). Changes in QT intervals were also greater in group 1 compared with group 2 (P = .02). Conclusion Among patients with ICDs, changes of Tamp after psychological stress were greater in those with subsequent arrhythmic events. This might signal proarrhythmic repolarization response and help identify patients who would benefit the most from ICD implantation and proactive management.
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Acute instances of distress can lead to immediate changes and even dramatic elevations in catecholamines.
“Acute instances of distress can lead to immediate changes and even dramatic elevations in catecholamines. 102-107”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [102]
The Results section, “Changes in catecholamines during stress” (page unavailable), reports that epinephrine rose 30% and norepinephrine 1.2% from baseline during laboratory-induced psychological stress. This supports a stress-related change, but the passage does not establish that it was immediate, and the reported increases do not support the claim of dramatic elevations in catecholamines generally. (LLM, conf=0.88)
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Emotional and physical precipitants of ventricular arrhythmia
Lampert, R., Joska, T., Burg, M. M., Batsford, W. P., McPherson, C. A., & Jain, D. (2002) · Circulation · doi:10.1161/01.cir.0000031733.51374.c1 · Cited by 347
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- Shusterman, 1998, Autonomic nervous system activity and the spontaneous initiation of ventricular tachycardia. ESVEM Investigators. Electrophysiologic Study Versus Electrocardiographic Monitoring Trial, J Am Coll Cardiol, 32, 1891, 10.1016/S0735-1097(98)00468-9 · DOI
- Shusterman, 2006, Upsurge in T-wave alternans and non-alternating repolarization instability precedes spontaneous initiation of ventricular tachyarrhythmias humans, Circulation, 113, 2280, 10.1161/CIRCULATIONAHA.105.607895 · DOI
- Brodsky, 1987, Ventricular tachyarrhythmia associated with psychological stress, JAMA, 257, 2064, 10.1001/jama.1987.03390150080039 · DOI
- Hemmingway, 2001, Social and psychosocial influences on sudden cardiac death, ventricular arrhythmia and cardiac autonomic function, Eur Heart J, 22, 1082, 10.1053/euhj.2000.2534 · DOI
- Lampert, 2005, Effects of psychological stress on repolarization and relationship to autonomic and hemodynamic factors, J Cardiovas Electrophysiol, 16, 372, 10.1046/j.1540-8167.2005.40580.x · DOI
- Kop, 2004, Effects of mental stress and exercise T-wave alternans in patients with implantable cardioverter defibrillators and controls, Circulation, 109, 1864, 10.1161/01.CIR.0000124726.72615.60 · DOI
- Lampert, 2009, Anger-induced T-wave alternans predict future ventricular arrhythmias in patients with implantable cardioverter-defibrillators, J Am Coll Cardiol, 53, 774, 10.1016/j.jacc.2008.10.053 · DOI · Paper page
- Swerdlow, 2011, Intracardiac electrogram T-wave alternans/variability increases before spontaneous ventricular tachyarrhythmias in implantable cardioverter-defibrillator patients: a prospective, multi-center study, Circulation, 123, 1052, 10.1161/CIRCULATIONAHA.110.986364 · DOI
- Cantillon, 2007, Predictive value of microvolt T-wave alternans in patients with left ventricular dysfunction, Am Coll Cardiol, 50, 166, 10.1016/j.jacc.2007.02.069 · DOI
- Shusterman, 2000, Enhancing the precision of ECG baseline correction: selective filtering and removal of residual error, Comput Biomed Res, 33, 144, 10.1006/cbmr.2000.1539 · DOI
- Nearing, 2002, Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy, J Appl Physiol, 92, 541, 10.1152/japplphysiol.00592.2001 · DOI
- Shusterman, 2004, Tracking repolarization dynamics in real-life data, J Electrocardiol, 37, 180, 10.1016/j.jelectrocard.2004.08.054 · DOI
- Pueyo, 2004, Characterization of QT interval adaptation to RR interval changes and its use as a risk-stratifier or arrhythmic mortality in amiodarone-treated survivors of acute myocardial infarction, IEEE Trans Biomed Eng, 51, 1511, 10.1109/TBME.2004.828050 · DOI
- Shusterman, 1999, Changes in autonomic activity and ventricular repolarization, J Electrocardiol, 32, 185, 10.1016/S0022-0736(99)90078-X · DOI
- Extramiana, 2010, Beat-to-beat T-wave amplitude variability in the long QT syndrome, Europace, 12, 130, 10.1093/europace/euq137 · DOI
- Tasic, 2009, T-wave variability as a risk stratifier in patients with dilated cardiomyopathy, PACE, 32, S155, 10.1111/j.1540-8159.2008.02274.x · DOI
- Taggart, 2009, Repolarization changes induced by mental stress in normal subjects and patients with coronary artery disease: effect of nitroglycerin, Psychosomatic Med, 71, 23, 10.1097/PSY.0b013e31818a1d56 · DOI
- Ribeiro, 2010, T-wave amplitude variability and the risk of death in Chagas disease, J Cardiovas Electrophysiol, 1
- Couderc, 2007, Repolarization variability in the risk stratification of MADIT II patients, Europace, 9, 717, 10.1093/europace/eum131 · DOI
- Antzelevitch, 2007, The role of spatial dispersion of repolarization in inherited and acquired sudden cardiac death syndromes, Am J Physiol Heart Circ Physiol, 293, H2024, 10.1152/ajpheart.00355.2007 · DOI
- Nearing, 2002, Progressive increases in complexity of T-wave oscillations herald ischemia-induced ventricular fibrillation, Circ Res, 91, 727, 10.1161/01.RES.0000038887.17976.33 · DOI
- Yan, 1998, Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome, Circulation, 98, 1928, 10.1161/01.CIR.98.18.1928 · DOI
- Shimizu, 1999, Cellular and ionic basis for T-wave alternans under long-QT conditions, Circulation, 99, 1499, 10.1161/01.CIR.99.11.1499 · DOI
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Levine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865
Dunbar, S. B., Dougherty, C. M., Sears, S. F., Carroll, D. L., Goldstein, N. E., Mark, D. B., McDaniel, G., Pressler, S. J., Schron, E., Wang, P., et al. (2012) · Circulation · doi:10.1161/cir.0b013e31825d59fd · Cited by 221
The insular cortex and the regulation of cardiac function
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Metadata
- Authors
- Abisse, S. S., Lampert, R., Burg, M., Soufer, R., & Shusterman, V.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Yale University (US)
- Corresponding author
- Shusterman, Vladimir
- Venue
- Journal of Electrocardiology
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 44
- Issue
- 6
- Pages
- 678-683
- ISSN
- 0022-0736 (ISSN-L)
- PMC
- PMC3200452
- OpenAlex
- W2044386053
- Cited by
- 20
- References
- 1
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 1 · 2012: 3
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Electrocardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association
- Yale University
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL 59619, HL071116, R43-44HL077116, R44HL077116, R01HL071116, R01HL059619)
- National Center for Research Resources (UL1RR024139)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- cardiac repolarization, ventricular tachyarrhythmia, psychological stress, mental arithmetic, implantable cardioverter-defibrillator, T-wave amplitude, QT interval, autonomic nervous system, arrhythmia risk prediction, Holter monitoring
- MeSH terms
- Aged, Catecholamines, Electrocardiography, Female, Heart Conduction System, Humans, Male, Middle Aged, Stress, Psychological, Defibrillators, Implantable, Tachycardia, Ventricular
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