Defibrillators help explain mystery of emotionally triggered sudden cardiac arrest

21 May 2005

Cardiac arrhythmias brought on by anger are more deadly than arrhythmias not caused by extreme emotion, according to a new study presented at Heart Rhythm 2005, the US Heart Rhythm Society's 26th Annual Scientific Sessions (4–7 May). The new study finds that the electrical characteristics of anger-triggered arrhythmias are more disorganised and unstable than arrhythmias unrelated to emotional events — a possible clue explaining why sudden cardiac arrest increases in people during stressful times.

"Our study suggests that anger is associated with more dangerous arrhythmias, which could possibly be due to the higher adrenaline levels associated with anger and stress," says Matthew Stopper, MD, lead author in the Department of Internal Medicine at Yale School of Medicine. "This could be a contributing factor as to why the rate of sudden death increases during natural disasters and war."

The Yale investigators had previously shown that anger predisposed people to having arrhythmias. They asked 24 patients with implantable cardiac defibrillators (ICDs) to keep a diary of their emotions before they received a shock for a cardiac arrhythmia. Using data from this earlier work, the current study compared the electrical characteristics of anger-triggered arrhythmias against arrhythmias not associated with anger. The new study finds that all anger-triggered arrhythmias were initiated by one or more premature ventricular contractions (PVC), while 68% of arrhythmias not caused by anger were initiated by PVCs.

"This study provides valuable insight into the mystery surrounding these heart disorders caused by anger," says Stephen C. Hammill, MD, the Heart Rhythm Society's president. "Learning more about the electrical characteristics of these emotionally-triggered events could help in the prevention and treatment of sudden cardiac arrest."

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