AIM: To study effects of psychological factors (anxiety and depression) on risk of sudden death in post-myocardial infarction patients (PMI); correlation of psychological factors with autonomic regulation of cardiac rhythm. MATERIAL AND METHODS: Heart rate variability (HRV) and psychological status (Mini-Mult method) were determined and Spilberger-Khanin test was made in 320 PMI patients (mean age 57+/-7.6 years, 246 males and 74 females). RESULTS: 56% examinees had anxiodepressive profile of personality by Mini-Mult test and high anxiety by Spilberger-Khanin test. This indicates the presence of depressive symptoms and anxiety in many PMI patients. These patients had lower HRV and more depressed parasympathic tonicity. The correlation analysis of psychological factors and HRV has revealed correlation between HRV deterioration and intensification of anxiety and depression. CONCLUSION: Those patients who died of myocardial infarction had more serious psychological disturbances than in the survivors as well as more significant disorders of autonomic regulation of sinus rhythm which contribute to development of fatal arrhythmia.