Key result
Severe stress during mobile calls linked to ~5.1-fold higher risk of ischemic ECG changes.
Why the study?
The cardiovascular effects of mobile phone use remain debated, and the role of conversation-induced stress and autonomic nervous system activation in ECG changes across different cardiovascular disease risk groups is less explored.
Do active mobile phone calls and conversation-induced stress induce electrocardiogram changes (ischemia, PVCs, QTc prolongation, and reduced HRV) across different cardiovascular risk groups?
Cohort (n=80)
Yes
Do active mobile phone calls and conversation-induced stress induce electrocardiogram changes (ischemia, PVCs, QTc prolongation, and reduced HRV) across different cardiovascular risk groups?
Active mobile phone calls, particularly when accompanied by severe psychological stress, are associated with acute ischemic ECG changes, increased PVCs, QTc prolongation, and reduced heart rate variability, predominantly in patients with high or very high cardiovascular risk.
Ischemic ECG changes during severe stress support heightened vigilance in emergency dispatch; leaves open causal inference and intervention effects.
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 .
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Farag et al. (2026) conducted a cohort in Cardiovascular disease risk (n=80). Active mobile phone calls (stratified by CVD risk and call stress) vs. Low/moderate CVD risk or mild/no stress during calls was evaluated on Ischemic ECG changes (ST-segment depression/T-wave inversion) (RR 5.1, 95% CI 1.7-15, p=<0.0001). Mobile phone calls with severe stress increased ischemic ECG changes 5-fold vs mild stress (RR 5.1; 95% CI 1.7-15; p<0.0001), occurring more in very high- vs low/moderate-risk patients (28.7% vs 9.1%).
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