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Influence of drugs on the relationship between sinus node recovery time and calculated sinoatrial conduction time in man

Wirkung von Pharmaka auf das Verhalten von Sinusknotenerholungszeit und sinuatrialer Leitungszeit

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Summary

Sinus node recovery time (SRT), the pacing rate with the maximal SRT, and calculated sinoatrial conduction time (SACT) were studied by overdrive atrial pacing and programmed premature atrial stimulation in 78 patients before and after the application of several antiarrhythmic drugs or of atropine.

The maximu SRT was usually observed at lower rates of atrial pacing after application of a drug that prolonged SACT, whereas the opposite behaviour was observed in the majority of cases in whom the drug tested shortened calculated SACT. However, this relationship was not observed in all cases which may be due to random changes of sinus node automaticity or sinoatrial conduction, or to the inability of programmed premature atrial stimulation to detect changes of SACT.

The results of this study further substantiate the importance of the properties of sinoatrial conduction for achieving a maximal depression of sinus node activity during high rate atrial pacing.

Zusammenfassung

Bei 78 Patienten wurden Sinusknotenerholungszeit, die Stimulationsfrequenz mit der maximalen Sinusknotenerholungszeit und die sinuatriale Leitungszeit mittels hochfrequenter und programmierter vorzeitiger atrialer Stimulation vor und nach Applikation verschiedener Antiarrhythmika oder von Atropin bestimmt.

Nach Gabe eines Pharmakons, das die sinuatriale Leitungszeit verlängerte, wurde die maximale Sinusknotenerholungszeit gewöhnlich bei einer niedrigeren Stimulationsfrequenz beobachtet als während der Kontrollmessung. Dagegen fand sich ein entgegengesetztes Verhalten der Stimulationsfrequenz mit maximaler Sinusknotenerholungszeit nach Gabe von Substanzen, die die sinuatriale Leitungszeit verkürzten. Dieses gegensinnige Verhalten wurde jedoch nicht bei allen Patienten beobachtet. Dies kann an spontanen Schwankungen der Sinusknotenautonomie liegen oder auf methodischen Problemen bei der Bestimmung der sinuatrialen Leitungszeit beruhen.

Die Ergebnisse weisen auf die Bedeutung der sinuatrialen Leitung hin, die das Ausmaß der Sinusknotendepression während hochfrequenter Vorhofstimulation mitbestimmt.

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  1. G. Breithardt

    Present address: Medizinische Klinik B, Universität Düsseldorf, Moorenstraße 5, D-4000, Düsseldorf, Germany

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  1. Medizinische Klinik B, Universität Düsseldorf, Moorenstraße 5, D-4000, Düsseldorf, Germany

    L. Seipel

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Breithardt, G., Seipel, L. Influence of drugs on the relationship between sinus node recovery time and calculated sinoatrial conduction time in man. Basic Res Cardiol 73, 68–76 (1978). https://doi.org/10.1007/BF01914656

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