The analysis of heart rate variability (HRV) has been recommended for the study of the impact of work-stress on the autonomic cardiac control. The literature related to the effect of work stress on physicians on-call is extremely limited. Our study aimed to evaluate the role of stress on the HRV of on-call physicians.
Twenty six healthy physicians (11 men,15 women) undertook a 24-hour Holter-ECG recording while being on-call, as well as on a normal work-day at least 3 days after the day on-call. The mean age was 34±7,49 years (range: 25-51 years). All recordings started at 3 p.m. and lasted 24 hours.
The physicians presented decreased values of Standard Deviation of all filtered RR intervals over the length of the analysis(SDNN) during the day-on call in comparison with a normal workday (SDNN: 89.9 and 110.9 respectively, p<0.05). The rhythm disturbances during the day on-call were clearly more (p<0.05) and included sinus tachycardia and bradycardia, sinus pauses, supraventricular tachycardia, as well as premature atrial and ventricular systoles.
Psychological and physical stress at working environment as well as sleep deprivation may result in adrenergic surge that predisposes to cardiac arrhythmias. In our study, the on-call physicians presented decreased SDNN. Although it is already known that decreased HRV correlates with increased morbidity and mortality, the studies about the clinical use of this marker in healthy subjects are few.
Our findings demonstrated a negative impact of stress on the cardiac rhythm during an on-call day. It would be interesting to further investigate the significance of occupational stress in arrhythmogenesis in healthy and non-healthy individuals as well as the prognostic value of decreased HRV seen in our study.
Stavros Mountantonakis, None.