Heart rate and QT variability in children with anxiety disorders: A preliminary report

Abstract

This study compared beat-to-beat heart rate and QT variability in children with anxiety disorders (n = 7) and normal controls (n = 15) by using an automated algorithm to compute QT intervals. An increase in QT variability appears to be associated with a higher risk for sudden cardiac death. A decrease in heart rate variability is also linked to significant cardiovascular events. Supine detrended QT variability, QT variability corrected for mean QT interval, and QTvi (a log ratio of QT variance normalized for mean QT over heart rate variability normalized for mean heart rate) were significantly higher in children with anxiety compared to controls (P < 0.05). The largest Lyapunov Exponent (LLE) of heart rate time series was significantly lower (P < 0.05) in children with anxiety compared to controls. These findings suggest a relative increase in sympathetic activity and a relative decrease in cardiac vagal activity in children with anxiety disorders, and are discussed in the context of the effects of tricyclics on cardiac autonomic function in children, and the rare occurrence of sudden death during tricyclic antidepressant treatment.

Decreased chaos of heart rate time series in children of patients with panic disorder

“…Our findings are in agreement with other investigators who have studied heart rate period changes in children with temperamental characteristics such as behavioral inhibition [Calkins and Fox, 1992;Marshall and Stevenson-Hinde, 1998] and shyness [Asendorpf and Meier, 1993]. Yeragani et al [2001] also failed to find significant dif ferences for any of the heart rate variability measures in frequency domain between children with anxiety disorders and normal controls. Kagan et al [1984Kagan et al [ , 1989 reported that behaviorally inhibited children had decreased heart rate variability and increased cardiac acceleration in response to cognitive stress.…”

Developmental Effects of Selective Breeding for an Infant Trait

“…Fetuses of highly anxious women show significant heart rate increases during a maternal stressor, whereas the fetuses of non-anxious women exhibit minor heart rate decreases (Monk et al, 2000;Monk et al, 2004;Monk, Myers, Sloan, & Fifer, 2003). Infant risk for depression and anxiety based on family associations are associated with higher heart rates and lower heart rate variability in response to stress (Yeragani, 1995;Yeragani, Rao, Pohl, Jampala, & Balon, 2001). Hyperarousal attributable to greater sympathetic activation appears to be a characteristic of anxious individuals, and particularly in children and adolescents (Biederman et al, 1990;Greaves-Lord et al, 2007;Kagan et al, 1989;Kagan et al, 1999;Yeragani et al, 2001;Yeragani, Pohl, Balon, Jampala, & Jayaraman, 2002).…”

Facilitation of Cardiac Vagal Activity by CRF-R1 Antagonists during Swim Stress in Rats

“…Emotions such as anger and anxiety are thought to increase sympathetic output, thereby increasing heart rate (HR) and risk of coronary heart disease or sudden cardiac death (Agelink et al, 2002;Johnsen et al, 2003;Kawachi et al, 1994;Nahshoni et al, 2004;Watkins et al, 1998;Wittstein et al, 2005;Yeragani et al, 2001Yeragani et al, , 2002. Alternatively, fear and feelings of hopelessness cause severe vagal activation resulting in bradycardia, which can lead to vasovagal syncope and asystole (Angrilli et al, 1997;Friedman et al, 1993;Hartel, 1987).…”