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Cited by 347Cardiac Health and Mental HealthCardiac electrophysiology and arrhythmiasCardiac pacing and defibrillation studies

Emotional and physical precipitants of ventricular arrhythmia

Open access
Lampert, Rachel, Joska, Tammy, Burg, Matthew M., Batsford, William P., McPherson, Craig A., Jain, Diwakar·2002·Circulation
DOI 10.1161/01.cir.0000031733.51374.c1
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Abstract

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.

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  • The adrenergic hyperactivation connected with intense emotions and anxiety can, in itself, predispose the patient to supraventricular and/or ventricular arrhythmias.

    “In addition, the adrenergic hyperactivation connected with intense emotions and anxiety can, in itself, predispose the patient to supraventricular and/or ventricular arrhythmias.25 -27”

    From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [25]

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Research works printed but not linked: 4

  1. Mittleman MA, Maclure M, Tofler GH, et al. Triggering of acute myo- cardial infarction by heavy physical exertion. N Engl J Med. 1993;329: 1677-1683.
  2. Kawachi I, Sparrow D, Vokonas PS, et al. Symptoms of anxiety and risk of coronary heart disease. Circulation. 1994;90:2225-2229.
  3. Dunbar SB, Kimble LP, Jenkins LS, et al. Association of mood distur- bance and arrhythmia events in patients after cardioverter defibrillator implantation. Depress Anxiety. 1999;9:163-168.
  4. Sears S, Rauch S, Handberg E, et al. Fear of exertion following ICD storm. J Cardiopulm Rehabil. 2001;21:47-49.

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Authors
Lampert, R., Joska, T., Burg, M. M., Batsford, W. P., McPherson, C. A., & Jain, D.
Affiliations
Dartmouth College (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-10
Volume
106
Issue
14
Pages
1800-1805
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000031733.51374.c1
OpenAlex
W2033555108
Cited by
347
References
38
Citations by year
2026: 7 · 2025: 4 · 2024: 8 · 2023: 8 · 2022: 10 · 2021: 10 · 2020: 19 · 2019: 11 · 2018: 9 · 2017: 8 · 2016: 17 · 2015: 19 · 2014: 15 · 2013: 19 · 2012: 24
FWCI
9.00
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords
ventricular arrhythmias, implantable cardioverter-defibrillator, sudden cardiac death, anger, emotional stress, physical activity, mood states, ICD shocks, coronary artery disease, arrhythmia triggers
MeSH terms
Affect, Aged, Anger, Arrhythmias, Cardiac, Electric Countershock, Emotions, Physical Exertion, Female, Heart Rate, Humans, Male, Stress, Psychological, Time Factors, Ventricular Fibrillation, Defibrillators, Implantable, Tachycardia, Ventricular, Ventricular Dysfunction

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