In the month following the September 11th, 2001 attacks, there was a spate of heart rhythm disturbances in cardiac patients - even those living far from the disaster sites.

That finding is reported in two articles in the latest issue of the Journal of the American College of Cardiology.

Dr. Jonathan S. Steinberg, at Columbia University College of Physicians and Surgeons in New York, and associates recruited 200 patients fitted with implantable cardioverter-defibrillator devices, or ICDs, which are intended to fire a corrective shock if a patient’s heart starts beating abnormally.

The participants were being seen for a regular check-up in New York clinics, and the investigators examined the data stored in the ICDs for the 3 months before 9/11 and for 13 months thereafter.

In the 30 days prior to 9/11, seven patients (3.5 percent) had at least episode in which the device fired, compared with 16 (8.0 percent) in the 30 days afterward - a 2.3-fold increase.

Steinberg collaborated with Dr. Omer L. Shedd, at the University of Florida, Gainesville, and colleagues to see if there was a similar effect on patients geographically removed from the attacks on 9/11.

The results were quite similar in this study, which included 132 ICD clinic patients undergoing routine follow-up in Florida. Fourteen patients (11 percent) had rhythm disturbances in the 30-day period after 9/11, compared with five (3.8 percent) in the preceding 30 days - a 2.8-fold increase.

Shedd’s group suggests that a primary prevention strategy should be developed to help cardiac patients during stressful times. This should take the form of a planned response by emergency services, the media, patients themselves, and their families.

Doctors could talk to anxiety-prone patients about preparations for dealing with stressful events, which might involve ant-anxiety medication or psychological counseling.

SOURCE: Journal of the American College of Cardiology, September 15, 2004.