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*Sumitra Sudharkodhy, Karthiyanee Kutty, Vinutha Shankar M. S., Patil N. J., Balan K.


Context: Medical students are exposed to various stresses like demanding medical education and different teaching protocols.4,5 Heart rate variability (HRV) is a simple and non-invasive indicator for the detection of cardiac autonomic dysfunction. This study was done to assess the effect of stress and anxiety on HRV. Aims:  To assess the perceived stress, anxiety and heart rate variability in first year medical students.  To correlate stress and anxiety to heart rate variability. Methods and Material: The study included one hundred and ten, first year M.B.B.S students, excluding students with any infections, metabolic diseases, cardio respiratory diseases and medications which alter the autonomic functions. Anxiety and Stress were measured using Spielberger state-trait anxiety inventory (STAI) and perceived stress scale (PSS) questionnaires respectively. Based on the scores students were assigned to stress & non-stress group and anxious & non-anxious group. The electrocardiogram (ECG) was recorded using a house built Analogue ECG Amplifier, which was further analysed using HRV analysis software. Results: STAI & PSS were analysed; those who have STAI score of above 40 come under anxious group and those with PSS score of 13 and above comes under stress group.62% students are both anxious as well as stressed. The parameters namely, mean heart rate, SDNN, RMSSD, LFnu and HFnu were correlated with stress and anxiety scores. During state-anxiety, there are significant increase in heart rate, RMSDD, LF domain, and LF/HF and during trait- anxiety there are significant increase in RMSDD and LF/HF ratio. In this study perceived stress is not significant with HRV. Conclusions: This study shows that during anxiety there is increased activity towards sympathetic, but no difference in parasympathetic activity and during perceived stress there is no significance with heart rate variability.

Keywords: Anxiety; Stress, Spielberger state-trait anxiety inventory, perceived stress scale, Heart rate variability.

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