Mental Stress May Induce QT‐Interval Prolongation and T‐Wave Notching (English)

In: Annals of Noninvasive Electrocardiology ;  12 ,  3 ;  251-259 ;  2007

Background: The effects of active and passive mental stress (PMS) on the QT interval were studied by using an intraindividual regression method of QT‐interval correction for heart rate.

Methods: Thirty healthy males (age 21.2 ± 1.8 years) performed a mental arithmetic for 1 minute, which was considered as active mental stress (AMS) because of the performance requirement. A 1‐minute unpleasant video clip was used for PMS. Two baseline and two (an early and a late) ECGs were prepared in both mental stress periods. The individual QT–RR relationship was assessed by linear regression analysis of 7–15 (11.0 ± 1.9) controlled QT–RR data pairs, also obtained from ECGs gained during a successive set of 9 isometric stretching exercises.

Results: Heart rate has increased significantly at both measurements in response to AMS (P < 0.0001), but not in response to passive stress. QTc significantly prolonged early in AMS (P = 0.0004), then normalized by the end of the period. During PMS, no significant QTc changes were observed. The evolution of bifid T waves was noted in 14 subjects: 8 presented bifid T waves during both AMS and exercise, and 6 during only exercise.

Conclusions: AMS and PMS elicit different cardiovascular reactions. Our results indicate that changes in the autonomic tone, probably abrupt sympathetic predominance, may cause QTc prolongation and bifid T waves. This suggests that besides stress quality and intensity, the dynamics of stress application and perception also influence repolarization.

Table of contents – Volume 12, Issue 3

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185
Circadian Variation in QT Dispersion Determined from a 12‐Lead Holter Recording: A Methodological Study of an Age‐ and Sex‐Stratified Group of Healthy Subjects
Hansen, Stig / Rasmussen, Verner / Larsen, Klaus / Torp‐Pedersen, Christian / Jensen, Gorm Boje | 2007
197
Dofetilide‐Induced Long QT and Torsades de Pointes
Aktas, Mehmet K. / Shah, Abrar H. / Akiyama, Toshio | 2007
203
Relationship between Beat‐to‐Beat Variability of RT‐Peak and RT‐End Intervals in Normal Controls, Patients with Anxiety, and Patients with Cardiovascular Disease
Yeragani, Vikram Kumar / Berger, Ronald / Desai, Nagaraj / Bar, Karl Juergen / Chokka, Pratap / Tancer, Manuel | 2007
210
Association of P‐Wave Duration, Dispersion, and Terminal Force in Relation to P‐Wave Axis among Outpatients
Prajapat, Laxman / Ariyarajah, Vignendra / Frisella, Mary E. / Apiyasawat, Sirin / Spodick, David H. | 2007
216
C‐Reactive Protein Is Associated with Heart Rate Variability
Madsen, Trine / Christensen, Jeppe Hagstrup / Toft, Egon / Schmidt, Erik Berg | 2007
223
Pacemaker Longevity: The World's Longest‐Lasting VVI Pacemaker
Katz, David / Akiyama, Toshio | 2007
227
Variable Interatrial Conduction Illustrated in a Hypertrophic Cardiomyopathy Population
Holmqvist, Fredrik / Platonov, Pyotr G. / Carlson, Jonas / Havmöller, Rasmus / Waktare, Johan E.P. / McKenna, William J. / Olsson, S. Bertil / Meurling, Carl J. | 2007
237
Computer‐Aided Systematized Approach to Pediatric ECG Analysis
Molina, Marcos S. / Benjo, Alexandre M. / Molina, Alessandra I. / Favarato, Desiderio / Tobias, Nancy / Garcia, Euler de Vilhena / Ramires, José A. F. / Pastore, Carlos Alberto | 2007
246
Dynamic Changes in T‐Wave Amplitude during Tilt Table Testing: Correlation with Outcomes
Mayuga, Kenneth A. / Fouad‐Tarazi, Fetnat | 2007
251
Mental Stress May Induce QT‐Interval Prolongation and T‐Wave Notching
Andrássy, Gábor / Szabo, Attila / Ferencz, Gyöngyvér / Trummer, Zsófia / Simon, Eszter / Tahy, Ádám | 2007
260
Electrical and Structural Remodeling in Left Ventricular Hypertrophy—A Substrate for a Decrease in QRS Voltage?
Bacharova, Ljuba | 2007
274
Antiarrhythmic Induced Electrical Storm in Brugada Syndrome: A Case Report
Joshi, Sandeep / Raiszadeh, Farbod / Pierce, Walter / Steinberg, Jonathan S. | 2007
279
Electrocardiographic Predictors of Arrhythmic Death –“What is the Role of Atrial Fibrillation?”
Dandapantula, Hari / Chandu, Laxman | 2007
280
Reply to Letter to the Editor from Drs. Dandapantula and Chandu entitled “Electrocardiographic Predictors of Arrhythmic Death –“What is the Role of Atrial Fibrillation?”
McLaughlin, Michael / Zimetbaum, Peter J. | 2007

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