Journal Article

Triggering of Ventricular Tachycardia by Meteorologic and Emotional Stress: Protective Effect of β-Blockers and Anxiolytics in Men and Elderly

Viktor Puli, Davor Eterovi, Dinko Miri, Lovel Giunio, Ajvor Lukin and Damir Fabijani

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 160, issue 11, pages 1047-1058
Published in print December 2004 | ISSN: 0002-9262
Published online December 2004 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwh335
Triggering of Ventricular Tachycardia by Meteorologic and Emotional Stress: Protective Effect of β-Blockers and Anxiolytics in Men and Elderly

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A circadian pattern with a morning peak and the triggering role of emotional stress have been suggested for ventricular arrhythmias. After controlling for participant baseline characteristics and medication used, the authors studied the association of emotional upset, physical activity, and meteorologic parameters with occurrence of ventricular tachycardia (VT) in 457 Croatian participants aged 11–88 years consecutively assigned to undergo continuous 24-hour Holter monitoring. In 2001, multivariate analysis of possible VT precipitators was performed separately for men, women, those aged <65 years, and those aged >64 years. A U-shaped pattern of wind speed (either very weak or very strong), rising relative air moisture, falling atmospheric pressure, and emotional upset were independent predictors of VT episodes in all participant subgroups. Positive association of VT with higher atmospheric temperature or pressure was observed in women and elderly. After adjustment for external triggers, a circadian variation in VT episodes persisted in women (p = 0.01) and those aged <65 years (p < 0.0001) only. A protective effect of β-blockers and anxiolytics was especially apparent for men and elderly, as well as an adverse effect of digitalis in women. Results suggest that meteorologic and emotional stress could be considered external triggers of VT, with age- and sex-dependent susceptibility.

Keywords: anti-arrhythmia agents; atmospheric pressure; circadian rhythm; sex; stress; tachycardia; temperature; Abbreviations: ANOVA, analysis of variance; VT, ventricular tachycardia.

Journal Article.  6889 words.  Illustrated.

Subjects: Public Health and Epidemiology

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