Exercise electrocardiography extinguishes persistent junctional rhythm in a patient with severe anorexia nervosa

Cardiology
Mori J KrantzPhilip S Mehler

Abstract

Among psychiatric conditions, anorexia nervosa carries the highest mortality, in part due to the propensity for rhythm disturbances among patients with advanced disease. Patients with anorexia nervosa are prone to both bradycardia and tachyarrhythmias, though mortality has not been associated with the former. To date, only one case of junctional rhythm in the setting of anorexia nervosa has been previously described, which was unremitting and required prolonged hospitalization. We report a case of persistent accelerated junctional rhythm where a formal exercise electrocardiography study demonstrated rapid reversion to sinus rhythm with graded exercise. Despite a 22-day hospitalization the patient never reverted permanently to sinus rhythm. This underscores the heightened vagal tone that may be seen among patients with severe anorexia nervosa. Despite this, it may be rapidly extinguished with sympathetic overdrive during exercise. In this context, exercise electrocardiography appears to be a safe, noninvasive means of assessing cardiac conduction and chronotropic reserve in this population.

References

Jan 1, 1985·Annals of Internal Medicine·J M IsnerJ Yager
Jan 1, 1993·Pacing and Clinical Electrophysiology : PACE·T KuritaK Shimomura
Apr 1, 1997·The International Journal of Eating Disorders·K J Neumärker
Jun 5, 2003·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Fabio GalettaFerdinando Pentimone
Jun 24, 2003·Journal of the American Academy of Child and Adolescent Psychiatry·Lluís MontJosep Brugada

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Citations

Apr 22, 2014·The Journal of Pediatrics·Cynthia H HoMerujan Y Uzunyan
Dec 17, 2014·International Journal of Cardiology·C VaursP Maury
Jan 15, 2016·Cardiology in the Young·Michael A Spaulding-BarclayPhilip S Mehler
Dec 30, 2015·The International Journal of Eating Disorders·Katherine V SachsMori J Krantz
Jul 15, 2015·The American Journal of Medicine·Patricia WestmorelandPhilip S Mehler
Nov 26, 2015·The International Journal of Eating Disorders·Jennifer L Gaudiani, Philip S Mehler
Apr 16, 2015·Journal of Eating Disorders·Philip S MehlerKatherine V Sachs
Apr 4, 2015·Journal of Eating Disorders·Philip S Mehler, Carrie Brown
Feb 9, 2018·The International Journal of Eating Disorders·Philip S MehlerJennifer Watts
Jan 10, 2020·Journal of Cardiovascular Electrophysiology·Morteza FarasatMori J Krantz
Feb 26, 2016·Medicine and Science in Sports and Exercise·Brian J CookKimberli McCallum

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