Both acute and chronic forms of psychological stress have been propose
d as precipitants of sudden cardiac death in patients with coronary ar
tery disease. However few information has been gained so far, about th
e effects of acute psychological stress in patients with ventricular p
reexcitation (WPW). Indeed such evaluation could be relevant to define
the individual arrhythmic risk in WPW. In this study 40 patients with
WPW syndrome and otherwise normal hearts were investigated, most of t
hem for agonistic sports aptitude assessment. Psychological profiling
was carried out with M.H. e., Wartegg, Toulouse-Pieron and Banati-Fisc
her tests. All conventional EP parameters were quantified, by trans-es
ophageal pacing, under basal conditions and during 6 minutes of mental
stress (a modified colour-word conflict task). The combined effect of
mental stress, postural changes and physical effort was evaluated as
well. Average ERPs of Kent and AV Node were both shortened by mental s
tress. This effect however was statistically significant only at rest,
in the upright position, at drive cycles of 600, 400 ms (p <0.05) and
320 ms (p <0.01). A proarrhythmic effect was observed in 6 subjects,
being AF (3 cases) or AVRT (3 cases) inducible only during mental stre
ss. Psychological profiling evidenced that proarrhythmic modification
of electrophysiological parameters induced during mental stress occurr
ed in individuals with a lack of aggressivity integration or blocked p
sychic energy, which results in a poor ''coping'' capability Conclusio
ns: Individual personality traits and coping style should be evaluated
as an independent risk factor, because they could play a pathogenic r
ole for the occurrence of life-threatening arrhythmias in WPW patients
, especially when engaged in agonistic sports or risky occupations imp
lying strong emotional involvement.