Nicholas Child1, Ben Hanson1, Martin Bishop1, Christopher A Rinaldi1, Julian Bostock1, David Western1, Michael Cooklin1, Mark O'Neil1, Matthew Wright1, Reza Razavi1, Jaswinder Gill1, Peter Taggart2. 1. From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.). 2. From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.). peter.taggart@uclh.nhs.uk.
Abstract
BACKGROUND: Mental stress and emotion have long been associated with ventricular arrhythmias and sudden death in animal models and humans. The effect of mental challenge on ventricular action potential duration (APD) in conscious healthy humans has not been reported. METHODS AND RESULTS: Activation recovery intervals measured from unipolar electrograms as a surrogate for APD (n=19) were recorded from right and left ventricular endocardium during steady-state pacing, whilst subjects watched an emotionally charged film clip. To assess the possible modulating role of altered respiration on APD, the subjects then repeated the same breathing pattern they had during the stress, but without the movie clip. Hemodynamic parameters (mean, systolic, and diastolic blood pressure, and rate of pressure increase) and respiration rate increased during the stressful part of the film clip (P=0.001). APD decreased during the stressful parts of the film clip, for example, for global right ventricular activation recovery interval at end of film clip 193.8 ms (SD, 14) versus 198.0 ms (SD, 13) during the matched breathing control (end film left ventricle 199.8 ms [SD, 16] versus control 201.6 ms [SD, 15]; P=0.004). Respiration rate increased during the stressful part of the film clip (by 2 breaths per minute) and was well matched in the respective control period without any hemodynamic or activation recovery interval changes. CONCLUSIONS: Our results document for the first time direct recordings of the effect of a mental challenge protocol on ventricular APD in conscious humans. The effect of mental challenge on APD was not secondary to emotionally induced altered respiration or heart rate.
BACKGROUND: Mental stress and emotion have long been associated with ventricular arrhythmias and sudden death in animal models and humans. The effect of mental challenge on ventricular action potential duration (APD) in conscious healthy humans has not been reported. METHODS AND RESULTS: Activation recovery intervals measured from unipolar electrograms as a surrogate for APD (n=19) were recorded from right and left ventricular endocardium during steady-state pacing, whilst subjects watched an emotionally charged film clip. To assess the possible modulating role of altered respiration on APD, the subjects then repeated the same breathing pattern they had during the stress, but without the movie clip. Hemodynamic parameters (mean, systolic, and diastolic blood pressure, and rate of pressure increase) and respiration rate increased during the stressful part of the film clip (P=0.001). APD decreased during the stressful parts of the film clip, for example, for global right ventricular activation recovery interval at end of film clip 193.8 ms (SD, 14) versus 198.0 ms (SD, 13) during the matched breathing control (end film left ventricle 199.8 ms [SD, 16] versus control 201.6 ms [SD, 15]; P=0.004). Respiration rate increased during the stressful part of the film clip (by 2 breaths per minute) and was well matched in the respective control period without any hemodynamic or activation recovery interval changes. CONCLUSIONS: Our results document for the first time direct recordings of the effect of a mental challenge protocol on ventricular APD in conscious humans. The effect of mental challenge on APD was not secondary to emotionally induced altered respiration or heart rate.
Authors: Peter Taggart; Peter Sutton; Chris Redfern; Velislav N Batchvarov; Katerina Hnatkova; Marek Malik; Ursula James; Avy Joseph Journal: Psychosom Med Date: 2005 May-Jun Impact factor: 4.312
Authors: Willem J Kop; David S Krantz; Bruce D Nearing; John S Gottdiener; John F Quigley; Mark O'Callahan; Albert A DelNegro; Ted D Friehling; Pamela Karasik; Sonia Suchday; Joseph Levine; Richard L Verrier Journal: Circulation Date: 2004-03-22 Impact factor: 29.690
Authors: Ben Hanson; Nick Child; Stefan Van Duijvenboden; Michele Orini; Zhong Chen; Ruben Coronel; Christopher A Rinaldi; Jaspal S Gill; Jaswinder S Gill; Peter Taggart Journal: Front Physiol Date: 2014-10-28 Impact factor: 4.566