Objective: To determine the relationship between electrodermal activity (EDA) and cardiac troponin in patients with paroxysmal sympathetic hyperactivity (PSH). Methods: This was a study with prospectively-identified patients and a retrospective analysis utilizing electrodermal data taken from the wrist-worn Empatica E4 device (Empatica Srl, Milan, Italy) and troponin values obtained from critically-ill patients with suspected PSH (N=10). The maximum EDA value and temporally-nearest cardiac troponin were correlated to test for significance using Pearson correlation coefficient. Results: A moderate correlation was found between EDA and troponin in 10 patients using the most temporally-proximal troponin to each patient's maximal EDA (r=0.634; p = 0.049). A subanalysis was performed excluding any patients whose available troponin data did not fall within seven days of their maximal EDA, which demonstrated a strong correlation (r=0.943; p = 0.005). No relationships between troponin and pulse, blood pressure, or temperature were found. Conclusions: This study establishes an association between wrist-worn EDA and a measure of possible myocardial injury in critically ill patients with PSH. Patients with elevated sympathetic activity may be at increased risk for concurrent cardiac injury or dysfunction, and thus EDA data from wrist-worn monitors may provide clinically significant data regarding sympathetic function.

Jong Woo Lee performs contract work for Teladoc, is a consultant for Biopharmaceuticals, is Site PI for UCB/Parexel, received a grant from NIH (R43NS120394), and received a grant from Epilepsy Foundation. Claus Reinsberger declares a grant from Heinz Nixdorf Westfalian Foundation, declares a grant from German Institute of Sports Science, serves as a consultant for the German Football Association (DFB), serves as a consultant for the Union of European Football Associations (UEFA), and is an associate editor for Journal of Science and Medicine in Sport.

Louis Beers received the Yawkey Nonprofit Internship Funding through Boston University.

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The IRB of Brigham and Women's Hospital gave ethical approval for this work, "Magnetic resonance spectroscopy and neurophysiology in severe brain injury" (2014P001623)

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