BIOBEHAVIORAL MEDIATORS OF PROGRAMMED ARRHYTHMIA

Project: Research project

Project Details

Description

Sudden death due to ventricular fibrillation and tachycardia is the leading
cause of death in the 20-64 year age group accounting for 450,000 deaths
annually. Although advances in prevention and treatment of coronary artery
disease have decreased cardiovascular mortality by 20% in the last decade
the mechanisms relating coronary disease to the precipitation and
termination of ventricular tachycardia are as yet unknown. Even if
coronary disease could be completely prevented, sudden cardiac death not
associated with atherosclerotic disease would still be a substantial health
problem. Therefore the search for neuroendocrine and psychosocial
mediators of tachyarrhythmic vulnerability is likely to produce scientific
and health benefits independent of those gained from the study of ischemic
heart disease.

Clinical studies of patients with recurrent ventricular tachycardia using
programmed arrhythmia induction provide a unique opportunity to examine the
relationship between biomedical, neuroendocrine and psychosocial
determinants of arrhythmia manageability and cardiac mortality. Over a
three year period 120 ventricular tachycardia patients and 40 arrhythmia
free, coronary disease controls will be evaluated on measures of
selfreported and inferred affects, social behavior, congnitive status, life
change and neuroendocrine secretory patterns. The principal hypotheses
are: 1) separation anxiety, hostility-directed-inward and
cortisol-catecholamine secretion will correlate with ease of arrhythmia
induction and termination in the tachycardia group, 2) these "high risk
affects" and neuroendocrine secretions will be lower in controls undergoing
cardiac catheterization, 3) depression, cognitive impairment and behavioral
disengagement will predict long term mortality in both groups.

Since Ischemic heart disease cannot as yet be reversed or prevented, the
evidence that biobehavioral factors are implicated in arrhythmogensis and
coronary mortality cannot be ignored. The results of the study are
intended to improve our knowledge of these factors which put the individual
at risk for arrhythmia and imminent death.
StatusFinished
Effective start/end date1/1/901/1/90

Funding

  • National Heart, Lung, and Blood Institute

ASJC

  • Endocrine and Autonomic Systems
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing
  • Internal Medicine
  • Epidemiology

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