Psychosomatic Medicine, Vol 49, Issue 4 410-421, Copyright © 1987 by American Psychosomatic Society

ORIGINAL ARTICLES

Significance of depression and cognitive impairment in patients undergoing programed stimulation of cardiac arrhythmias

GJ Kennedy, MA Hofer, D Cohen, R Shindledecker and JD Fisher

Although depression and cognitive impairment have been associated with excess mortality following heart surgery, the relationship of these factors to death following treatment for cardiac arrhythmias is unknown. We prospectively examined the associations between biobehavioral factors, mortality, and arrhythmia manageability in 88 patients undergoing programed electrical stimulation for the diagnosis and treatment of supraventricular and ventricular tachyarrhythmias or syncope of unknown origin. Statistically significant relationships were identified between depression and mortality, and between cognitive impairment and mortality. No relationships were observed between cognitive impairment or psychologic profile and arrhythmia severity or treatment efficacy. Our data suggest that arrhythmia morbidity and mortality may in part be a function of cognitive and emotional impairments that lessen the individual's capacity to comply with lifesaving therapy, maintain a stable physiologic milieu, and continue an adaptive emotional life. Failure to recognize the clinical significance of these impairments in patients at risk for sudden cardiac death will contribute to the current difficulty reducing the death and disability associated with cardiac arrhythmias.

This article has been cited by other articles:

				J. A Blumenthal, A. Sherwood, S. D. Rogers, M. A. Babyak, P. Murali Doraiswamy, L. Watkins, B. M. Hoffman, C. O'Connell, J. J. Johnson, S. M. Patidar, et al. Understanding prognostic benefits of exercise and antidepressant therapy for persons with depression and heart disease: the UPBEAT study rationale, design, and methodological issues Clinical Trials, October 1, 2007; 4(5): 548 - 559. [Abstract] [PDF]

				R. M. Carney, W. B. Howells, J. A. Blumenthal, K. E. Freedland, P. K. Stein, L. F. Berkman, L. L. Watkins, S. M. Czajkowski, B. Steinmeyer, J. Hayano, et al. Heart Rate Turbulence, Depression, and Survival After Acute Myocardial Infarction Psychosom Med, January 1, 2007; 69(1): 4 - 9. [Abstract] [Full Text] [PDF]

				W. Whang, C. M. Albert, S. F. Sears Jr, R. Lampert, J. B. Conti, P. J. Wang, J. P. Singh, J. N. Ruskin, J. E. Muller, M. A. Mittleman, et al. 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., April 5, 2005; 45(7): 1090 - 1095. [Abstract] [Full Text] [PDF]

				M. M. Burg, M. C. Benedetto, R. Rosenberg, and R. Soufer Presurgical Depression Predicts Medical Morbidity 6 Months After Coronary Artery Bypass Graft Surgery Psychosom Med, January 1, 2003; 65(1): 111 - 118. [Abstract] [Full Text] [PDF]

				J. C. Peterson, M. E. Charlson, P. Williams-Russo, K. H. Krieger, P. A. Pirraglia, B. S. Meyers, and G. S. Alexopoulos New Postoperative Depressive Symptoms and Long-Term Cardiac Outcomes After Coronary Artery Bypass Surgery Am J Geriatr Psychiatry, April 1, 2002; 10(2): 192 - 198. [Abstract] [Full Text] [PDF]

				H. Hemingway, M. Malik, and M. Marmot Social and psychosocial influences on sudden cardiac death, ventricular arrhythmia and cardiac autonomic function Eur. Heart J., July 1, 2001; 22(13): 1082 - 1101. [PDF]

				K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]

				R. M. Carney, K. E. Freedland, R. C. Veith, and A. S. Jaffe Can Treating Depression Reduce Mortality After an Acute Myocardial Infarction? Psychosom Med, September 1, 1999; 61(5): 666 - 675. [Abstract] [Full Text] [PDF]

				A. Rozanski, J. A. Blumenthal, and J. Kaplan Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy Circulation, April 27, 1999; 99(16): 2192 - 2217. [Abstract] [Full Text] [PDF]

				A. H. Glassman and P. A. Shapiro Depression and the Course of Coronary Artery Disease Am J Psychiatry, January 1, 1998; 155(1): 4 - 11. [Abstract] [Full Text]

				N. Frasure-Smith, F. Lesperance, and M. Talajic Depression and 18-Month Prognosis After Myocardial Infarction Circulation, February 15, 1995; 91(4): 999 - 1005. [Abstract] [Full Text]