Analysis of Mental-Stress Induced Arrhythmia in Individuals with Recent Myocardial Infarction Open Access

Otchere, Baffour (Spring 2022)

Permanent URL:



Stress has been found to be associated with sudden cardiac death and cardiovascular diseases; however, these associations have not been extensively studied like the traditional risk factors of cardiovascular diseases. 

Methods and Results:

A total of 162 individuals were included in this study. The average age of the cohort was 53±6 years and 81 of the study participants (52%) were women. There were 123 cases of myocardial infarction (MI) and 32 controls, who did not have MI, in this study. Cases and controls were subjected to acute mental stress and heart rhythm was recorded using Holter monitors and analyzed using General Electric MARS 8.0.2 software. On average, there were 1.27 (95% CI: 0.46, 2.08) premature atrial contractions (PAC) and 2.56 (95% CI: 1.22, 3.89) premature ventricular contractions (PVC) during the mental stress periods, compared to 0.95 (95% CI: 0.43,1.47) PACs and 2.22 (95% CI: 0.61, 3.83)PVCs during a matched period pre-stress. Participants had an average of 0.32 (95% CI: -0.26, 0.90) more PACs and 0.34 (95% CI: -1.32, 2.00) more PVCs during mental stress compared to pre-stress rest. PAC counts were more likely to increase acutely during mental stress in depressed versus non-depressed individuals (OR= 3.60, 95% CI: 1.31, 9.86); PVC count increases were more likely to occur in the recovery period (OR= 3.01 vs. pre-stress rest, 95% CI: 1.12, 8.08) in depressed vs. non-depressed individuals. However, these associations reduced and lost statistical significance after multivariable adjustment for demographic and cardiovascular risk factors.


Overall, we observed slight, non-significant increases in PAC and PVC burden during stress versus pre-stress rest. Depression was associated with higher arrhythmia burden during stress and recovery, although these relationships were explained by multivariable adjustment for traditional risk factors. More studies are needed to further explore these relationships and their clinical and public health relevance.

Table of Contents


METHODS       8

RESULTS          11


BIBLIOGRAPHY            17

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
Subfield / Discipline
  • English
Research Field
Committee Chair / Thesis Advisor
Last modified

Primary PDF

Supplemental Files