Summary
This study describes the relationship between the antiarrhythmic efficacy of β- blockade with atenolol and the increased sympathetic tone during submaximal ergometric exercise in 18 patients with various inducible supraventricular tachycardias.
At rest, atenolol prevented or controlled (i.e. normalisation of ventricular rate) pacing- induced supraventricular tachycardias in 13/19 arrhythmias. In the remaining patients the tachycardia or echo zones were both prolonged or shortened. Ergometric exercise after β- blockade changed the tachycardia or echo zones in 5/8 arrhythmias (prolongation or shortening), compared with the resting conditions of β- blockade. In 1 patient with Wolff- Parkinson- White syndrome, the tachycardia could be reinitiated during physical activity, and in another patient atrial flutter was no longer inducible under the increased sympathetic tone. In general, the tachycardia or echo zones are not uniformly changed by both β- blockade and ergometric exercise, particularly in situations where they are combined.
It is concluded that increasing the sympathetic tone by ergometric exercise may considerably change the electrophysiological and antiarrhythmic properties of β- blocking agents. These effects of physical activity on the electrophysiological behaviour of the specialised cardiac- conduction system should be taken into account when the arrhythmia- suppressing potency of any antiarrhythmic drug is evaluated.
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Hombach, V., Höpp, H.W., Braun, V. et al. Relevance of Physical Activity to the Antiarrhythmic Effects of β-Blockade on Supraventricular Tachycardias. Drugs 25 (Suppl 2), 186–192 (1983). https://doi.org/10.2165/00003495-198300252-00054
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DOI: https://doi.org/10.2165/00003495-198300252-00054