Association between heart rate turbulence and anxiety symptom levels

General anxiety disorder (GAD) is a condition characterized by extreme, persistent, and uncontrollable worry lasting for more than six months. In addition to cognitive and behavioral symptoms, individuals with GAD also commonly exhibit physical signs and autonomic nervous system symptoms. Heart rate turbulence (HRT) is the assessment of sinus rhythm cycle fluctuation occurring in the presence of ventricular premature contraction (VPC), and is a parameter used to show autonomic dysfunction. There are no studies in the literature investigating the association between GAD and HRT. The aim of the present study was to determine the association between HRT and anxiety symptom levels. The study included 72 consecutive patients. The patients were fitted with Holter devices for 24-hr rhythm monitoring and asked to complete the Hospital Anxiety and Depression Scale (HADS) to assess their anxiety symptom levels. The study participants were grouped based on the severity of their anxiety symptoms as low (group 1) and high (group 2). Of the 72 participants, 26 had high anxiety levels and 46 had low anxiety levels. There was a significant difference between the two groups in HRT parameters. Patients in the high-anxiety group had significantly higher turbulence onset (TO) and significantly lower turbulence slope (TS) when compared with the low-anxiety group. Anxiety score was positively correlated with TO (r=0.296, p=0.01) and negatively correlated with TS (r=-0.304, p=0.009). In the present study, we found that patients with high anxiety levels showed greater abnormality in HRT parameters, indicating autonomic dysfunction.