Rachel Lampert, MD Associate Professor of Medicine (Cardiology/electrophysiology) Electrophysiology Service

BA, Harvard College, 1983; MD, Vanderbilt University, 1987 Internship and residency, Internal Medicine, Bellevue/New York University; Cardiology fellowship, Yale University

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, Rosenfeld L, Batsford W, Lee F, McPherson C: Circadian Variation of Sustained Ventricular Tachycardia in Patients with Coronary Artery Disease and Implantable Cardioverter-Defibrillators. Circulation, 90:241-247, 1994.



Lampert R, Jain D, Burg MM, Batsford WP, McPherson CA: Destabilizing effects of mental stress on ventricular arrhythmias in patients with implantable cardioverter-defibrillators. Circulation 2000; 101:158-164.



Lampert R, Baron S, McPherson C, Lee F: Heart Rate Variability During the Week of September 11, 2001. JAMA, 2002; 288: 575.



Lampert R, Joska T, Burg M, Batsford WP, McPherson CA, Jain D: Emotional and Physical Precipitants of Ventricular Arrhythmia. Circulation 2002; 106: 1800-1805



Lampert R, Ickovics JR, Viscoli CJ, Horwitz RI, Lee FA: Effects of Propranolol on Recovery of Heart Rate Variability Following Acute Myocardial Infarction and Relation to Outcome in the Beta-Blocker Heart Attack Trial. Am J Cardiol 2003;91 :137-142



Lampert R, McPherson CA, Clancy JF, Caulin-Glaser T, Rosenfeld LE, Batsford, WP: Gender Differences in Ventricular Arrhythmia Recurrence in Patients with Coronary Artery Disease and Implantable Cardioverter Defibrillators. J Am Coll Cardiol 2004; 43/12: 2293-2299



Burg, M, Lampert, R, Joska, T, Batsford, W, Jain, D. Psychological Traits and Emotion-triggering of ICD Shock-terminated Arrhythmias. Psychosomatic Medicine, 2004;66:898-902.



Lampert, R, Ickovics, J, Horwitz, R. Lee, F.: Depressed Autonomic Nervous System Function in African-Americans and Individuals of Lower Social Class: A Potential Mechanism of Race and Class-Related Disparities in Health Outcomes. Am Heart J 2005; 150:153-60



Lampert, R, Shusterman, V, Burg, M, Lee, F, Earley, C, Goldberg, A, McPherson, C, Batsford, W, Soufer, R: Effects of Psychologic Stress on Repolarization and Relationship to Autonomic and Hemodynamic Factors. J Cardiovasc Electrophysiology; 2005; 16: 372-377.



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



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.

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.

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, 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.

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Last modified:Wednesday, 09-Apr-2008 11:20:41 EDT (PL).