Analysis of Mental-Stress Induced Arrhythmia in Individuals with Recent Myocardial Infarction Open Access
Otchere, Baffour (Spring 2022)
Published
Abstract
Background:
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.
Conclusions:
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
INTRODUCTION 7
METHODS 8
RESULTS 11
DISCUSSION 15
BIBLIOGRAPHY 17
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