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Sunday, November 1, 2009
Learning Objective 1: discuss the effects of music on cardiac conduction in the sedate patient.
Learning Objective 2: recognize the potential role of music in the sedate patient.
Introduction: Heart rate variability (HVR) is a cardiovascular predictor of morbidity and mortality. However, little is known regarding the effects of music on th eautonomic function of the heart. The purpose of this study was to examine the effects of music on cardiac conduction, recovery and effective refractory periods (ERP) of patients presenting to the electrophysiology (EP) laboratory.
Methods: A prospective, case control study was performed on 20 patients, who presented with standard indications for an EP study. The musical selection was Canon in D by Johann Pachelbel, performed on a non-amplified Grand Concert Pedal Harp. Once patients were sedated the music was played for 10 minutes. Data was collected during the initial phase of the EP study (control), five minutes into the musical intervention, and five minutes after the music was completed. The data measurements included: conduction intervals (AA, AH, HV), sino-atrial conduction time (SACT), sinus node recovery time (SNRT), and ERP.
Results: Lengthening of the AA interval (heart rate slowing), SNRT, and AV nodal ERP were observed, consistent with parasympathetic tone. A significant shortening of the ventricular ERP was observed (Table 1.).
Conclusions: Measures of parasympathetic tone were increased. In addition, a statistically significant shortening of the ventricular ERP was observed suggesting a sympathetic component. Response to music is a combination of sympathetic and parasympathetic influences and both were active in the sedated patient. Further research is warranted regarding the impact of music on cardiac conduction.
Table 1.
Methods: A prospective, case control study was performed on 20 patients, who presented with standard indications for an EP study. The musical selection was Canon in D by Johann Pachelbel, performed on a non-amplified Grand Concert Pedal Harp. Once patients were sedated the music was played for 10 minutes. Data was collected during the initial phase of the EP study (control), five minutes into the musical intervention, and five minutes after the music was completed. The data measurements included: conduction intervals (AA, AH, HV), sino-atrial conduction time (SACT), sinus node recovery time (SNRT), and ERP.
Results: Lengthening of the AA interval (heart rate slowing), SNRT, and AV nodal ERP were observed, consistent with parasympathetic tone. A significant shortening of the ventricular ERP was observed (Table 1.).
Conclusions: Measures of parasympathetic tone were increased. In addition, a statistically significant shortening of the ventricular ERP was observed suggesting a sympathetic component. Response to music is a combination of sympathetic and parasympathetic influences and both were active in the sedated patient. Further research is warranted regarding the impact of music on cardiac conduction.
Table 1.
| Variable | Control | Post Music | p |
| AA | 670.3 | 724.8 | 0.14 |
| AH | 103.0 | 106.1 | 0.26 |
| HV | 49.5 | 47.3 | 0.34 |
| SNRT | 1017.1 | 1079.3 | 0.12 |
| SACT | 173.0 | 191.2 | 0.30 |
| AERP | 245.1 | 248.1 | 0.68 |
| AVNERP | 342.4 | 379.7 | 0.09 |
| VERP | 249.3 | 242.2 | 0.05* |
*Indicates significance (p<0.05).