Stress and Cardiac Arrhythmias

Stress can exert adverse effect on cardiovascular health. Psychosocial stress adversely affects the autonomic homeostasis. This in turn can result in metabolic abnormalities, inflammation and dysfunction of endothelium [1]. Changes in the autonomic homeostasis can be a major trigger for ventricular tachyarrhythmias [2]. Increased sympathetic nervous activity can cause increased proarrhythmic repolarization instability leading to spontaneous ventricular arrhythmias. During stress-induced autonomic nervous system activity, the heart rate rises and the heart rate variability indices like low frequency power falls before the onset of ventricular tachycardia [3]. Psychological stress has been shown to induce T wave alternans, which in turn predicts future ventricular tachyarrhythmia events [4]. Fluctuations in T wave amplitude after psychological stress are predictive of subsequent arrhythmic events [5].