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American Journal of Epidemiology 2004 160(11):1047-1058; doi:10.1093/aje/kwh335
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Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

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

Viktor Puli1 , Davor Eterovi2, Dinko Miri1,3, Lovel Giunio1,3, Ajvor Lukin1 and Damir Fabijani1

1 Division of Cardiology, Department of Medicine, University Hospital Split, Split, Croatia.
2 Department of Biophysics and Scientific Methodology, University School of Medicine, Split, Croatia.
3 University School of Medicine, Split, Croatia.

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 ß-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.

anti-arrhythmia agents; atmospheric pressure; circadian rhythm; sex; stress; tachycardia; temperature

Abbreviations: Abbreviations: ANOVA, analysis of variance; VT, ventricular tachycardia.


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