The effects of human contact on cardiac arrhythmia in coronary care patients.

Abstract

It is part of common wisdom that interactions between a doctor or a nurse and a patient can modify patients's cardiac activity. However, the ubiquity of that knowledge has tended to obscure recognition of the fact that the magnitude, generality, and mechanisms of the cardiovascular effects of human contact are poorly understood. To explore the effects of human contact on the heart activity, coronary care patients were studied by noting on a continuous electrocardiogram each time any person came in contact with the patient. Results of these studies have shown that human contact, can have major effects on cardiac function of coronary care patients. These effects include phenomena such as heart rate changes of over 30 beats/minute, a doubling of the frequency of abnormal heart beats, and major changes in the conduction of electrical impulses in the heart and may take place with such routine clinical interactions as pulse taking and comforting behavior. Similar responses to human contact observed in patients on a shock-trauma unit who were paralyzed with d-tubocurarine suggest that such responses are central in origin, are not dependent on changes in respiration or movement, and can occur in subjects without pre-existing cardiac pathology. Moreover a number of studies over the past decade have shown that human contact can have major effects on the cardiovascular functioning of healthy animals, including dogs and horses These results indicate the need for quantification of the phyciological effects of many kinds of clinical interactions and the necessity for specification of ongoing human interactions accompanying epidemiological studies of the frequency of arrhythmia in coronary patients of the effects of antiarrhythmic drugs on that frequency. Although the extent and responsible mechanisms for such effects are not yet fully known, additional studies are currently underway aimed at uncovering such knowledge.