Effect of pharmacologic autonomic blockade on ventriculoatrial conduction

Anne Hamilton Dougherty, Robert L. Rinkenberger, Gerald Naccarelli

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

To determine the influence of autonomic tone on retrograde ventriculoatrial (VA) conduction, incre mental atrial and ventricular pacing was performed before and after pharmacologic autonomic blockade in 28 patients. VA conduction during ventricular pacing was demonstrated, with highest frequency in patients capable of 1:1 atrioventrlcular (AV) conduction at atrial paced cycle lengths of 300 ms or less (7 of 7, 100%). In subjects with 1:1 AV conduction at minimum cycle lengths of 300 to 500 ms, 14 of 21 (67%) demonstrated VA conduction in the control state; however, only 12 of 21 (57%) did so after autonomic blockade. The lowest frequency was observed in those capable of 1:1 AV conduction at minimum cycle lengths of 505 ms or more before and after autonomic blockade (2 of 7, [29%], p < 0.02 compared with values in the first group). No change in the mean minimum ventricular paced cycle length at which 1:1 VA conduction could be maintained was demonstrated after autonomic blockade. In individual subjects, incremental change in this cycle length after autonomic blockade correlated positively with the corresponding change in minimum atrial cycle length at which 1:1 AV conduction could be maintained (r = 0.62, p < 0.005), and was concordant in direction in 18 of 21. In conclusion, the sympathetic and parasympathetic modulation of VA conduction is balanced and concordant in direction to the effect on AV nodal conduction.

Original languageEnglish (US)
Pages (from-to)1274-1279
Number of pages6
JournalThe American Journal of Cardiology
Volume57
Issue number15
DOIs
StatePublished - Jun 1 1986

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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