Mental Stress May Lead to Abnormal Left Atrial Electrophysiology

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The percentage of participants showing left atrial abnormality was larger on ECGs obtained at stress and recovery vs rest.
The percentage of participants showing left atrial abnormality was larger on ECGs obtained at stress and recovery vs rest.

HealthDay News — Acute mental stress is associated with abnormal left atrial electrophysiology, according to a study published in the Journal of Cardiovascular Electrophysiology.

Wesley T. O'Neal, MD, MPH, from the Emory University School of Medicine in Atlanta, and colleagues examined whether acute mental stress results in abnormal left atrial electrophysiology in 422 patients with stable coronary heart disease. Patients underwent mental stress testing with a speech task. P-wave terminal force in lead V1 (PTFV1) was defined as the duration times the value of the depth of the downward deflection of the P-wave in lead V1 measured on digital electrocardiograms (ECGs). PTFV1 ≤−4,000 µV/ms defined electrocardiographic left atrial abnormality. Mean PTFV1 values were compared during stress and recovery with those at rest.

The researchers found that PTFV1 became more negative during mental stress compared with rest (mean change, −348; 95% confidence interval, −515 to −182; P <.001), and there was no change at recovery (mean change, 12; 95% confidence interval, −148 to 172; P =.89). The percentage of participants showing left atrial abnormality was larger on ECGs obtained at stress and recovery vs rest (39% and 34%, respectively, vs 30%).

"Acute mental stress alters left atrial electrophysiology, suggesting that stressful situations promote adverse transient electrical changes to provide the necessary substrate for atrial fibrillation," the authors write.

Reference

O'Neal WT, Hammadah M, Sandesara PB, et al. The association between acute mental stress and abnormal left atrial elctrophysiology [published online July 20, 2017]. J Cardiovasc Electrophysiol. doi: 10.1111/jce.13295.

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