{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:17:11Z","timestamp":1793222231249,"version":"4.5.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Anger and extreme stress can trigger potentially fatal cardiovascular events in susceptible people. Political elections, such as the 2016 US presidential election, are significant stressors. Whether they can trigger cardiac arrhythmias is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In this retrospective case\u2010crossover study, we linked cardiac device data, electronic health records, and historic voter registration records from 2436 patients with implanted cardiac devices. The incidence of arrhythmias during the election was compared with a control period with Poisson regression. We also tested for effect modification by demographics, comorbidities, political affiliation, and whether an individual's political affiliation was concordant with county\u2010level election results. Overall, 2592 arrhythmic events occurred in 655 patients during the hazard period compared with 1533 events in 472 patients during the control period. There was a significant increase in the incidence of composite outcomes for any arrhythmia (incidence rate ratio [IRR], 1.77 [95% CI, 1.42\u20132.21]), supraventricular arrhythmia (IRR, 1.82 [95% CI, 1.36\u20132.43]), and ventricular arrhythmia (IRR, 1.60 [95% CI, 1.22\u20132.10]) during the election relative to the control period. There was also an increase in specific types of arrhythmia, including atrial fibrillation (IRR, 1.50 [95% CI, 1.06\u20132.11]), supraventricular tachycardia (IRR, 3.7 [95% CI, 2.2\u20136.2]), nonsustained ventricular tachycardia (IRR, 1.7 [95% CI, 1.3\u20132.2]), and daily atrial fibrillation burden (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). No significant interaction was found for sex, race\/ethnicity, device type, age \u226565\u00a0years, hypertension, coronary artery disease, heart failure, political affiliation, or\u00a0concordance between individual political affiliation and county\u2010level election results.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">There was a significant increase in cardiac arrhythmias during the 2016 US presidential election. These findings suggest that\u00a0exposure to stressful sociopolitical events\u00a0may trigger arrhythmogenesis in susceptible people.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020559","type":"journal-article","created":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T15:00:11Z","timestamp":1621522811000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Arrhythmia Risk During the 2016 US Presidential Election: The Cost of Stressful Politics"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0944-6864","authenticated-orcid":false,"given":"Lindsey","family":"Rosman","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4636-8698","authenticated-orcid":false,"given":"Elena","family":"Salmoirago\u2010Blotcher","sequence":"additional","affiliation":[{"name":"Centers for Behavioral and Preventive Medicine The Miriam Hospital Providence RI"},{"name":"Schools of Medicine and Public Health Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafat","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Medicine University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quefeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2036-9254","authenticated-orcid":false,"given":"Anthony J.","family":"Mazzella","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Lawrence Klein","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Bumgarner","sequence":"additional","affiliation":[{"name":"Rex HospitalUniversity of North Carolina at Chapel Hill Health Raleigh NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Gehi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine University of North Carolina at Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7290-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707427"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.7063"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.06.151"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0261"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91234-L"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.04.058"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.032"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.596189"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2015.04.008"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000031733.51374.C1"},{"key":"e_1_3_2_13_2","first-page":"445","article-title":"Political advertising in 2016: the presidential election as outlier?","volume":"14","author":"Fowler EF","year":"2016","unstructured":"Fowler EF, Ridout TN, Franz MM. 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