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AHA: Anger Episode Can Trigger Arrhythmia in ICD Patients

Feeling very angry associated with nearly 17-fold greater risk of implantable cardioverter defibrillator discharge

MONDAY, Nov. 13 (HealthDay News) -- Patients with implantable cardioverter defibrillators, or ICDs, may be at greater risk of ventricular arrhythmias after an episode of anger, particularly if they have a history of ICD discharge, implant within the previous six months or left ejection fraction of less than 30 percent, according to a report presented at the American Heart Association's Scientific Sessions in Chicago.

Christine Albert, M.D., M.P.H., of the Brigham and Women's Hospital in Boston, and colleagues conducted a prospective, nested case crossover study in which they interviewed 1,188 patients about their frequency and intensity of anger. Over a two-year period, there were 271 episodes of ICD discharge and in 199 cases, patients were interviewed within 72 hours of the event.

Overall, 7.5 percent of events were preceded within one hour by an episode of at least moderate anger. Moderate anger was associated with a 3.2-fold higher risk of ICD discharge and being very angry/furious was associated with a 16.7-fold higher risk.

The study was observational so it isn't clear if anxiolytics, anger management or changing behavior can help prevent ventricular arrhythmias, said Albert. "We didn't have an intervention," she said, "but you get asked these questions all the time by your patients, so I don't think sharing this information with patients would be premature."

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