Rachel J. Lampert MD
Associate Professor of Medicine (Cardiology)
Arrhythmias, Stress, and the Autonomic Nervous System
Although psychologic stress and sudden cardiac death have been strongly correlated in epidemiological studies, the underlying physiologic link remains poorly understood. The ICD population allows evaluation of effects of mental stress on arrhythmia. Recent investigation has included evaluation of effects of mental stress on ventricular tachycardia as well as mechanisms and prognostic implications of this effect. Ongoing studies include emotional triggering of atrial fibrillation and the role of stress reactivity.
A second, related area of interest involves heart rate variability, a measurement of autonomic balance derived from ambulatory ECG monitoring. Heart rate variability can provide a measure of effects of acute or chronic stress. Previous investigations include a study of correlations of socioeconomic status and life stress with heart rate variability, and an ongoing study of the predictive value of heart rate variability changes with stress.
Clinical aspects of ICD therapy, including safety of sports for patients with ICDs represent another avenue of research.
- Lampert, R., Shusterman, V, Burg, M, Batsford, W, McPherson, C, Soufer, R.: Anger-induced T-wave alternans predicts future ventricular arrhythmias in patients with implantable cardioverter-defibrillators, JACC, 2009: 53:774-8
- Lampert, R, Soufer, R, McPherson, CA, Batsford, WP, Tirado, S, Earley, C, Goldberg, A, Shusterman, V. Implantable cardioverter-defibrillator shocks increase T-wave alternans. J Cardiovasc Electrophysiol, 2007: 18:512-517.
- Stopper, M,Joska, T, Burg, M, Batsford, W, McPherson, C, Jain, D, Lampert, R. Electrophysiologic Characteristics of Anger-triggered Arrhythmias. Heart Rhythm, 2007 4:268-73.
- Lampert, R, Cannom, D, Olshansky, B. Safety of Sports in Patients with Implantable Cardioverter-defibrillators: A Survey of Heart Rhythm Society Members. J Cardiovasc Electrophysiol, 2006 17:1-5.
- Goldberger, Z, Elbel, B, McPherson, C, Paltiel, AD, Lampert R. Cost Advantage of Dual versus Single Chamber Cardioverter Defibrillator Implantation. J Am Coll Cardiol, 46:850-7.
- Whang , W, Albert, C, Sears, S, Lampert, R, Conti, J, Wang, P, Singh, J, Ruskin, J, Muller, J, Mittleman, M, for the TOVA investigators: Depression as a Predictor for Appropriate Shocks among Patients with Implantable Cardioverter-Defibrillators: Results from the Triggers of Ventricular Arrhythmias (TOVA) Study. J Am Coll Cardiol, 2005 45:1090-1095.