Destabilizing Effects of Mental Stress on Ventricular Arrhythmias in Patients With Implantable Cardioverter-Defibrillators

Lampert, Rachel; Jain, Diwaker; Burg, Matthew M.; Batsford, William P.; McPherson, Craig A.

doi:10.1161/01.cir.101.2.158

Cited by 185 publications

(110 citation statements)

References 24 publications

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“…Research regarding rumination and/or worry has been dominated by clinical/health psychology, with rumination and worry thought to be implicated in the aetiology of a number of psychological disorders, e.g., depression and anxiety (Lyubomirsky, Caldwall, & NolenHoeksema, 1998;Mellings & Alden, 2000), and associated with increased physical symptom reporting (Hazlett & Haynes, 1992), intrusive off-task thoughts (Sarason, Pierce, & Sarason, 1996), negative self-evaluations, diminished feelings of control and feelings of helplessness (Lyubomirsky, Kasri, & Zehm, 2003). Furthermore, laboratory studies have shown prolonged physiological arousal and delayed recovery in individuals who ruminate or who are asked to recall stressful events (Glynn, Christenfeld, & Gerin, 2002;Ironson et al, 1992;Lampert, Jain, Burg, Batsford, & McPherson, 2000;Roger & Jamieson, 1988). Barlow & DiNardo (1991) proposed that worry is "fundamentally a presenting characteristic of all anxiety disorders with the possible exception of simple phobia" (p. 115); and worry also occurs frequently in major depression (Chelminski & Zimmerman, 2003).…”

Section: The Link Between Rumination and Worrymentioning

confidence: 99%

Assessing treatments used to reduce rumination and/or worry: A systematic review

Querstret

Cropley

2013

Clinical Psychology Review

195

112

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Perseverative cognitions such as rumination and worry are key components of mental illnesses such as depression and anxiety. Given the frequent comorbidity of conditions in which rumination and worry are present, it is possible they are underpinned by the same cognitive process. Furthermore, rumination and worry appear to be part of a causal chain that can lead to long-term health consequences, including cardiovascular disease and other chronic conditions. It is important therefore to understand what interventions may be useful in reducing their incidence. This systematic review aimed to assess treatments used to reduce worry and/or rumination. As we were interested in understanding the current treatment landscape, we limited our search from 2002-2012. Nineteen studies were included in the review and were assessed for methodological quality and treatment integrity. Results suggested that mindfulness-based and cognitive behavioural interventions may be effective in the reduction of both rumination and worry; with both Internet-delivered and face-to-face delivered formats useful. More broadly, it appears that treatments in which participants are encouraged to change their thinking style, or to disengage from emotional response to rumination and/or worry (e.g., through mindful techniques), could be helpful. Implications for treatment and avenues for future research are discussed.

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Section: The Link Between Rumination and Worrymentioning

confidence: 99%

Assessing treatments used to reduce rumination and/or worry: A systematic review

Querstret

Cropley

2013

Clinical Psychology Review

195

112

View full text Add to dashboard Cite

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“…The hypothesis of partly ischemia-associated arrhythmic events seems to be supported by studies reporting mental stress-induced platelet activation and plasma coagulation [28][29][30] which may prove disadvantageous to coronary blood flow. On the other hand, Lampert et al 31 monitored ICD recipients electrographically and measured left ventricular ejection fraction noninvasively in an experimental stress setting (mental arithmetic and anger recall), but did not find signs of ischemia in 9 of 10 patients (8 of these had coronary artery disease). In this study, ventricular tachyarrhythmias were faster and more difficult to terminate, but could not be induced more easily during mental stress.…”

Section: Mental Stress and Tachyarrhythmiasmentioning

confidence: 99%

“…Another mental stress-associated arrhythmogenic factor may be sympatho-adrenergic activation, which has been demonstrated in the laboratory setting by measuring increase of norepinephrine levels during mental stress. 31,32 Physical Stress, Sexual Activity, and Tachyarrhythmias…”

Section: Mental Stress and Tachyarrhythmiasmentioning

confidence: 99%

Triggering effect of physical and mental stress on spontaneous ventricular tachyarrhythmias in patients with implantable cardioverter‐defibrillators

Fries

König

Schäfers

et al. 2002

Clinical Cardiology

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SummaryBackground: Physical and mental stress as well as sexual activity are potential triggering factors of acute coronary events and sudden cardiac death.Hypothesis: These factors may also trigger recurrence of spontaneous ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillators (ICDs).Methods: We performed a case-crossover study in 43 consecutive patients with 95 symptomatic, ICD-documented tachyarrhythmic events and calculated the relative risk of tachyarrhythmia recurrence during physical and mental stress. Physical and mental activity was graded on a 4-step intensity scale, and stress was defined as physical exertion or mental stress with an intensity grade ≥ II during or up to 1 h before arrhythmia recurrence. Relative risk was determined taking into account the habitual weekly stress frequency of each patient.Results: Physical stress was present in 26% (n = 25), mental stress in 24% (n = 23), and sexual activity in 2% (n = 2) of analyzed events. The weekly habitual stress frequency was 8 ± 8 (median 7) for physical stress, 6 ± 6 (median 4) for mental stress, and 0.5 ± 0.5 (median 0.25) for sexual activity. Thus, relative risk of arrhythmia recurrence during the presence of stress was 7.5 for physical activity (95% confidence interval [CI] 5.2-11.1), 9.5 (CI 6.3-14.5) for mental activity, and 7.5 (CI 2.3-24.8) for sexual activity.Conclusions: Physical and mental stress as well as sexual activity are factors that significantly increase relative risk of spontaneous recurrence of sustained ventricular tachyarrhyth-

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“…Results revealed that SBP levels during metal task and SBP reactivity (increases) were highest for the severely ischemic group and lowest for controls (Krantz et al, 1991). Acute, laboratory-induced anger as part of a mental stress task has also been found to increase the risk of cardiac arrhythmias associated with sudden cardiac death in CAD patients with implantable cardioverter-defibrilators (Kop et al, 2004;Lampert, Jain, Burg, Batsford, & McPherson, 2000).…”

Section: Stress Reactivity In Chd Patientsmentioning

confidence: 99%

Heart Rate Variability, Catecholamine and Hemodynamic Responses During Rest and Stress in Coronary Artery Disease Patients: The PIMI Study

Ghambaryan¹

2007

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Altered cardiac autonomic balance has been shown to be a predictor of adverse cardiac events in patients with cardiovascular decease (CAD). Alteration of the sympatho-vagal balance of heart regulation may be more evident during periods of mental stress. The high frequency (HF) component of heart rate variability (HRV) is a marker of the parasympathetic regulation of the heart. The meaning of the low frequency (LF) component of HRV is controversial, but it may represent the sympathetic modulation of heart regulation. Plasma catecholamine levels (epinephrine and norepinephrine) are markers of sympathetic nervous system action. Increases in hemodynamic (blood pressure and heart rate) responses to stress are predominantly regulated by the sympathetic branch of the autonomic nervous system (ANS). The relationships among the frequency domains of HRV, hemodynamics, and catecholamine level were examined at rest and during speech mental stress in 147 CAD patients from the Psychophysiological Investigations of Myocardial Ischemia (PIMI) study. At rest, there were no significant associations between HRV measures, hemodynamic responses, and plasma catecholamine levels. However, at peak stress levels, analyses of variance revealed a significant inverse relation between HF levels and epinephrine (Epi), (univariate F (3, 132) = 2.9; p= .037); and a significant inverse relation between LF and catecholamine levels, (multivariate F (6, 258) = 3.7; p =.001). At peak stress levels, HF levels were inversely related to systolic blood pressure (SBP) and heart rate (HR) (F SBP (3, 141) = 3.9; p =0.01; and F HR (3, 141) = 7.2; p < 0.001). At peak stress levels LF was inversely related to SBP and HR, (F SBP (3, 140) = 8.9; p < 0.001; and F HR (3, 140) = 4.0; p = 0.009). These findings suggest that associations of the vagal components (HF) of HRV with sympathetic markers in CAD patients are only revealed under conditions of mental stress. In addition, based on the data,

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Destabilizing Effects of Mental Stress on Ventricular Arrhythmias in Patients With Implantable Cardioverter-Defibrillators

Abstract: Mental stress alters VT cycle length and termination without evidence of ischemia. This suggests that mental stress may lead to sudden death through the facilitation of lethal ventricular arrhythmias.

Cited by 185 publications

References 24 publications

Assessing treatments used to reduce rumination and/or worry: A systematic review

Assessing treatments used to reduce rumination and/or worry: A systematic review

Triggering effect of physical and mental stress on spontaneous ventricular tachyarrhythmias in patients with implantable cardioverter‐defibrillators

Heart Rate Variability, Catecholamine and Hemodynamic Responses During Rest and Stress in Coronary Artery Disease Patients: The PIMI Study

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