Mental Stress May Induce QT‐Interval Prolongation and T‐Wave Notching
- 5 July 2007
- journal article
- Published by Wiley in Annals of Noninvasive Electrocardiology
- Vol. 12 (3), 251-259
- https://doi.org/10.1111/j.1542-474x.2007.00169.x
Abstract
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. 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. 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. 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.Keywords
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