Psychophysiologic responses of invasive cardiologists in an academic catheterization laboratory

Am Heart J. 2006 Feb;151(2):522-8. doi: 10.1016/j.ahj.2005.03.044.


Background: This study examined the psychophysiologic responses of invasive cardiologists during cardiac catheterizations. Because occupations are most stressful when one is not in control, the effect of a teaching versus an autonomous role on the psychophysiologic response of invasive cardiologists was investigated.

Methods: The subjects were 9 invasive cardiologists. Psychophysiologic variables such as state anxiety and salivary cortisol levels were measured before and after each invasive cardiologist performed 7 cardiac catheterizations. Heart rate was measured before, during, and after procedures. Three procedures were studied while invasive cardiologists were in the primary operator (autonomous) role with full responsibility and control, whereas 4 were studied while the subjects were in the secondary assistant (teaching) role with full responsibility and no control.

Results: There were no significant differences in physiologic arousal (heart rate and salivary cortisol levels) between catheterizations performed in the autonomous role versus those in the teaching role. However, the perceived anxiety scores were higher when in the teaching role versus when in the autonomous role. There were significant differences in psychophysiologic measurements of stress between less experienced cardiologists (out of training < 5 years) and more experienced cardiologists (out of training > 5 years). Less experienced invasive cardiologists had significantly higher trait anxiety (38.4 vs 31.7, P = .001), baseline salivary cortisol levels (0.51 vs 0.33, P = .01), and heart rate change (50.1 vs 27.4 beats/min, P = .001) during procedures compared with more experienced cardiologists.

Conclusions: Although there were no overall differences in the physiologic response to the autonomous and teaching roles, there was a higher perceived state of anxiety when in the teaching role. Less experienced invasive cardiologists had higher psychophysiologic measurements of stress during invasive procedures than did more experienced cardiologists.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anxiety / physiopathology
  • Anxiety / psychology
  • Arousal / physiology
  • Blood Pressure / physiology
  • Cardiac Catheterization / psychology*
  • Cardiology* / education
  • Clinical Competence
  • Electrocardiography
  • Heart Rate / physiology
  • Humans
  • Hydrocortisone / analysis
  • Male
  • Middle Aged
  • Professional Autonomy
  • Psychophysiology
  • Respiration
  • Saliva / chemistry
  • Stress, Psychological / physiopathology*
  • Stress, Psychological / psychology*
  • Teaching*


  • Hydrocortisone