{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:40:09Z","timestamp":1769604009877,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Women and Health Foundation"},{"name":"The Swedish Heart and Lung Association"},{"name":"Department of Cardiology, Karolinska University Hospital"},{"name":"Women and Health Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Palpitations, particularly common in women, are generally considered benign symptoms rarely caused by clinically important arrhythmias. Nevertheless, palpitations may cause anxiety, depression, and decreased health-related quality of life (HRQOL). This study investigates to what degree palpitations cause symptoms such as anxiety and depression and affect HRQOL in women and whether direct feedback of underlying heart rhythm during palpitations decrease anxiety and depression and increase HRQOL in women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The study included 821 women, age 21\u201388\u2009years (mean 57\u2009\u00b1\u200911\u2009years), with symptomatic palpitations recruited using social media. For 60\u2009days, the participants used a handheld electrocardiogram (ECG)-recording device (Coala Heart Monitor) connected to their smartphones. ECG was recorded twice a day and when symptoms were present and was automatically algorithm-interpreted with immediate response to the user. Non-benign arrhythmias were also analysed manually. Questionnaires addressing anxiety and depression\u2014Hospital Anxiety and Depression Scale (HADS), Generalized Anxiety Disorder (GAD-7), HRQOL (RAND-36), and Symptoms Checklist: Frequency and Severity (SCL)\u2014were analysed before and after the data were collected. A total of 101\u00a0804 ECG recordings were automatically analysed. In 94%, sinus rhythm or premature atrial\/ventricular contraction were recorded; in 6%, atrial fibrillation or supraventricular tachycardia were recorded. Apart from premature ventricular contractions, no ventricular arrhythmias were documented. Anxiety and depression (HADS and GAD-7) decreased (P\u2009&amp;lt;\u20090.001) as did frequency and severity of symptoms, and HRQOL increased in all domains (P\u2009&amp;lt;\u20090.001) at the 2-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Instant analysis of the ECG with direct response during palpitations decreases symptoms, anxiety, and depression and increases HRQOL in women.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvaa031","type":"journal-article","created":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T04:13:25Z","timestamp":1609474405000},"page":"402-410","source":"Crossref","is-referenced-by-count":7,"title":["Instant electrocardiogram feedback with a new digital technique reduces symptoms caused by palpitations and increases health-related quality of life (the RedHeart study)"],"prefix":"10.1093","volume":"20","author":[{"given":"Carina","family":"Carnl\u00f6f","sequence":"first","affiliation":[{"name":"Department of Cardiology, Karolinska University Hospital, M97, S-141 86 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3659-5101","authenticated-orcid":false,"given":"Karin","family":"Schenck-Gustafsson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Karolinska University Hospital, K2 Medicine, Solna, Norrbacka, S-17177 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-3493","authenticated-orcid":false,"given":"Mats","family":"Jensen-Urstad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Karolinska University Hospital, C2-82, S-141 86 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6885-6548","authenticated-orcid":false,"given":"Per","family":"Insulander","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Karolinska University Hospital, C2-82, S-141 86 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"key":"2021062918332799400_zvaa031-B1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1080\/14017431.2017.1385837","article-title":"Women with PSVT are often misdiagnosed, referred later than men, and have more symptoms after ablation","volume":"51","author":"Carnlof","year":"2017","journal-title":"Scand Cardiovasc J"},{"key":"2021062918332799400_zvaa031-B2","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/0140-6736(93)91155-F","article-title":"Investigation of palpitations","volume":"341","author":"Brugada","year":"1993","journal-title":"Lancet"},{"key":"2021062918332799400_zvaa031-B3","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1093\/qjmed\/hcg017","article-title":"Characteristics of patients presenting to a cardiac clinic with palpitation","volume":"96","author":"Mayou","year":"2003","journal-title":"QJM"},{"key":"2021062918332799400_zvaa031-B4","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1001\/archinte.1995.00430160124012","article-title":"The clinical course of palpitations in medical outpatients","volume":"155","author":"Barsky","year":"1995","journal-title":"Arch Intern Med"},{"key":"2021062918332799400_zvaa031-B5","volume-title":"Panic Disorder (Attack)","author":"Cackovic","year":"2020"},{"key":"2021062918332799400_zvaa031-B6","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0022-3999(97)00209-2","article-title":"Chest pain, palpitations and panic","volume":"44","author":"Mayou","year":"1998","journal-title":"J Psychosom Res"},{"key":"2021062918332799400_zvaa031-B7","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1093\/europace\/eur130","article-title":"Management of patients with palpitations: a position paper from the European Heart Rhythm Association","volume":"13","author":"Raviele","year":"2011","journal-title":"Europace"},{"key":"2021062918332799400_zvaa031-B8","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1001\/archinte.1997.00440260085013","article-title":"Unrecognized paroxysmal supraventricular tachycardia. 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