Is stress arrythmogenic in inherited long QT syndrome?

January 01, 0001

Is stress arrythmogenic in inherited long QT syndrome?

These Finnish researchers examined whether stressful life events and prolonged mental stress are associated with arrhythmic events in patients with inherited long QT syndrome (LQTS). Participants (n=566) had a molecularly established mutation of KCNQ1, KCNH2 or SCN5A channel (LQT1, LQT2 and LQT3 respectively). The control group consisted of their 614 non-affected relatives. Stressful life events were indexed and prolonged mental stress was indexed by vital exhaustion (VE) measured with the Maastricht Questionnaire.

The researchers found: "Multinomial logistic regression analysis including patients with LQTS with and without arrhythmic events and the control subjects showed an age- and sex-adjusted association of stressful life events OR=1.15 and VE (OR=3.33) with symptomatic status of LQTS. Symptomatic patients with LQTS had experienced more stressful life events (OR=1.16) and the level of VE (OR=3.40) was more than three times higher among patients with LQTS with arrhythmic events than in asymptomatic LQTS mutation carriers. The association between stressful life events and arrhythmic events was independent of age, sex, specifically focused medication and LQTS subtype."

The researchers concluded: "A history of stressful life events and prolonged mental stress are associated with arrhythmic events in LQTS in this large sample of molecularly defined patients with LQTS. It is important for future studies to assess how strong these predisposing factors are for arrhythmic events in LQTS."

This study suggest prolonged mental stress may be arrhymogenic in patients with inherited long QT syndrome, but further research is warranted.

For the full abstract, click here.

Heart 96(16):1281-1286, 1 August 2010 © 2010 BMJ Publishing Group Ltd & British Cardiovascular Society
A history of stressful life events, prolonged mental stress and arrhythmic events in inherited long QT syndrome. T Hintsa, S Puttonen, L Toivonen, K Kontula, H Swan, L Keltikangas- Järvinen. Correspondence to: Taina Hintsa: [email protected]

Category: K. Circulatory. Keywords: long QT syndrome, LQTS, stress, vital exhaustion, arrhythmia, case-control study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 14 September 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.