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Kim and colleagues¹ demonstrated a reduction in heart rate variability (HRV) among older women with depression and no underlying coronary artery disease (CAD). The authors note that decreased HRV reflects a relative excess of sympathetic nervous system activity and is predictive of malignant arrhythmias and sudden cardiac death. While not explicitly stated, an extension of their findings is that diminished HRV may predispose older women with depression to sudden cardiac death even in the absence of established CAD. While this possibility is speculative, an analogous scenario may be inferred among young women with anorexia nervosa.

Among psychiatric disorders, anorexia nervosa has the highest mortality rate. This is likely due to a high incidence of sudden cardiac death, unrelated to the presence of CAD.² Although some have suggested that QT interval prolongation may explain this phenomena, supporting evidence for this assertion is at best conflicting.³ We recently observed a significant decrease . . . [Full Text of this Article]

AUTHOR INFORMATION
Mori J. Krantz, MD; Philip S. Mehler, MD

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