Psychological traits and emotion-triggering of ICD shock-terminated arrhythmias.
OBJECTIVE
We have previously reported on the triggering of arrhythmia and hence, implanted cardioverter-defibrillators (ICD) shock by strong emotion. The purpose of the present study was to examine whether concordant psychological traits distinguish patients who experience emotion-triggered ICD shock.


METHODS
Two hundred forty ICD patients completed the Speilberger Trait Anxiety and Anger Inventories and Anger Expression Scale, and the abridged Cook-Medley Hostility Scale approximately 2 months after ICD implantation. Patients were also given a structured diary to record mood states retrospectively for the period 0 to 15 minutes preceding ICD shock and for a period corresponding to the same time of day 1 week later. Patients who reported emotion-triggered ICD shock were compared on concordant psychological measures to patients who did not.


RESULTS
Patients who reported at least moderate anger in the 0 to 15 minutes before ICD shock scored significantly higher on Speilberger Trait Anger (24.18 +/- 3.97 vs. 17.04 +/- 2.17, p < .0001), and Cook-Medley Aggressive Responding (5.76 +/- 0.75 vs. 3.96 +/- 1.30, p < .0001) and Hostile Affect (3.59 +/- 0.80 vs. 2.04 +/- 1.02, p < .0001), and lower on Speilberger Anger Control (7.94 +/- 1.43 vs. 10.64 +/- 1.19, p < .001) than those who did not. In multivariate analysis, only Trait Anger remained a significant predictor of anger-triggered shock (chi2 = 7.10, p < .008). Patients who reported at least moderate anxiety in the 0 to 15 minutes before ICD shock scored significantly higher on Speilberger Anxiety (22.43 +/- 1.65 vs. 19.96 +/- 1.71, p < .0001) than those who did not.


CONCLUSIONS
Stable psychological factors are associated with risk for ICD-shock triggered by concordant strong emotion.
Burg
Matthew M
MM
VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA. mb2358@columbia.edu
Lampert
Rachel
R
Joska
Tammy
T
Batsford
William
W
Jain
Diwakar
D
D000368:Aged; D000786:Anger / Q000502:physiology; D001007:Anxiety / Q000523:psychology; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000628:therapy*; D003327:Coronary Disease / Q000523:psychology* / Q000628:therapy*; D017147:Defibrillators, Implantable; D004644:Emotions / Q000502:physiology*; D005260:Female; D006791:Hostility; D006801:Humans; D008297:Male; D010551:Personality / Q000502:physiology; D010555:Personality Inventory; D013315:Stress, Psychological / Q000523:psychology; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy