title: Triggering of ventricular tachycardia by meteorologic and emotional stress: protective effect of beta-blockers and anxiolytics in men and elderly.
abstract: 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 beta-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.
authors.affiliation: Division of Cardiology, Department of Medicine, University Hospital Split, Split, Croatia. viktor.culic@st.htnet.hr
authors.forename: Viktor
authors.initials: V
authors.lastname: Culić
authors.forename: Davor
authors.initials: D
authors.lastname: Eterović
authors.forename: Dinko
authors.initials: D
authors.lastname: Mirić
authors.forename: Lovel
authors.initials: L
authors.lastname: Giunio
authors.forename: Ajvor
authors.initials: A
authors.lastname: Lukin
authors.forename: Damir
authors.initials: D
authors.lastname: Fabijanić
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001274:Atmospheric Pressure; D002648:Child; D002940:Circadian Rhythm; D017523:Croatia; D015716:Electrocardiography, Ambulatory; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017678:Sex Distribution; D013315:Stress, Psychological / Q000150:complications*; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000319:Adrenergic beta-Antagonists; D014151:Anti-Anxiety Agents