Effect of mobile phone calls on holter eelectrocardiogram changes among different cardiovascular risk groups
E Farag, I A. Elsherbiny, T Elgendy, M A ElkotAbstract
Background
The cardiovascular effects of mobile phone (MP) use remain a subject of public concern and scientific debate. While some attribute changes to electromagnetic fields, the role of conversation-induced stress and autonomic nervous system (ANS) activation is less explored.
Purpose
This study aimed to evaluateElectrocardiogram (ECG) changes during active MP calls in patients stratified by cardiovascular disease (CVD) risk.
Methods
In this prospective cohort study, 80 patients (recruited from our University Hospitals) underwent 24-hour Holter monitoring. Participants were stratified into low-to-moderate, high, and very high CVD risk groups using the Systematic Coronary Risk Evaluation 2 (SCORE2) system. A total of 280 phone calls were analyzed for ischemic changes (ST-segment depression/T-wave inversion), premature ventricular contractions (PVCs), QT corrected (QTc) interval changes, and heart rate variability (HRV). Stress levels during calls were self-reported.
Results
Ischemic ECG changes occurred in 20.7% of calls, with significantly higher incidence in very high-risk (28.7%) and high-risk (19.4%) groups compared to low/moderate-risk patients (9.1%; p=0.014). Severe stress during calls was associated with a 5-fold higher risk of ischemic changes compared to mild stress (RR: 5.1, 95% CI: 1.7–15; p<0.0001). Increased CVD risk was associated with increase in the incidence of PVCs (p<0.05) . Severe stress during calls was associated with a 3.7-fold higher risk of PVCs compared to no stress (RR: 3.7, 95% CI: 1.2–9.54; p<0.05). There was a significant prolongation of the QTc interval during calls (median 439 ms vs. 421 ms baseline; p=0.0001), most pronounced in high-risk groups. A positive correlation was found between stress degree and QTc changes(r=0.126, p=0.035). HRV during active MP calls in both the high risk and the very high risk groups was significantly lower than the low-to-moderate(p<0.001).
Conclusion
Mobile phone calls can trigger significant ECG changes, including ischemia, PVCs, and QTcprolongation, particularly in high-risk cardiovascular patients. These changes appear to be driven by stress-induced sympathetic activation rather than direct electromagnetic effects, suggesting that acute psychological stress during communication is a critical modulator of cardiac stability in vulnerable individuals .