To determine if there is any correlation between electrodermal activity (EDA) data taken from a wrist-worn device and cardiac troponin levels in critically ill patients with paroxysmal sympathetic hyperactivity (PSH).

PSH describes a specific dysautonomia causing recurrent elevations in the sympathetic nervous system, often occurring following a traumatic brain injury. It is often accompanied by physical symptoms such as tachycardia, tachypnea, hypertension, and diaphoresis. EDA offers a means of monitoring pure sympathetic activity without any parasympathetic confounding. The recognition and management of EDA are important, as patients with symptomatic sympathetic hyperactivity have less favorable outcomes. Part of this may be due to the stress recurrent tachycardia places on the heart, potentially leading to cardiac dysfunction. This study examines the relationship of EDA activity with serum troponin elevation.

This was a prospective study investigating a sample population of critically ill patients with PSH (N=10). EDA data taken from the Empatica E4 wrist-worn device and troponin values taken closest temporally to the maximum EDA value were correlated with a Pearson correlation coefficient.

There was a moderate correlation found between maximum EDA and troponin values (r = 0.634; p = 0.049). There were no significant relationships between troponin and pulse or blood pressure.

Given the relationship between EDA and troponin identified in this study, wrist-worn EDA monitors may be used to identify and monitor potential cardiac dysfunction in critically ill patients with PSH. Patients fitting these criteria may benefit from continued surveillance of their sympathetic activity.