Response of Accessory AV Pathways to Exercise and Catecholamines

  • Samuel Lévy
  • Jean-Paul Broustet
  • Marc Metge
  • Roland Cointe
  • Gérard Faugère
  • Raymond Gérard


There has been increasing interest in the last decade in the role played by the autonomic nervous system in tachycardia induction and termination [1–3]. Furthermore, recent reports have provided evidence that accessory pathway properties may be influenced by exercise and catecholamines [4–8]. Most of the data available concern atrioventricular (AV) pathways, and we shall focus our discussion on this type of accessory connection which is associated with the Wolff-Parkinson-White (WPW) syndrome. As developed elsewhere in this volume, tachyarrhythmias associated with WPW syndrome include both reciprocating tachycardias and atrial flutter-fibrillation. The changes induced by exercise and catecholamines on both normal pathway and accessory pathway may affect both types of tachyarrhythmias.


Cycle Length Refractory Period Accessory Pathway Effective Refractory Period Right Ventricular Apex 
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  1. 1.
    Krikler D, Curry P: Atypical initiation of reciprocating tachycardia in the Wolff-ParkinsonWhite syndrome. In Reentrant Arrhythmias. Mechanisms and Treatment. Kulbertus H. (ed.), University Park Press, Baltimore, 1976, p. 144.Google Scholar
  2. 2.
    Waxman MB, Wald RW, Sharma AD, Huerta F, Cameron DA: Vagal techniques for termination of paroxysmal supraventricular tachycardia. Am. J. Cardiol. 46: 655, 1980.PubMedCrossRefGoogle Scholar
  3. 3.
    Benson DW Jr, Gallagher JJ, Sterba R, Klein GJ, Armstrong BE: Catecholamine-induced double tachycardia: case report in a child. PACE 3: 96, 1980.PubMedCrossRefGoogle Scholar
  4. 4.
    Broustet JP, Lévy S, Vircoulon B, Guern P, Clementy J, Choussat A: Syndrome de WolffParkinson-White. Comportement au cours de l’épreuve d’effort limitée par les symptômes. Arch. Mal Coeur 72: 625, 1979.PubMedGoogle Scholar
  5. 5.
    Lévy S, Broustet JP, Clémenty J, Vircoulon B, Guern P, Bricaud H: Syndrome de WolffParkinson-White. Corrélations entre l’exploration électrophysiologique et l’effet de l’épreuve d’effort sur l’aspect électrocardiographique de préexcitation. Arch. Mal Coeur 72: 634, 1979.PubMedGoogle Scholar
  6. 6.
    Strasberg B, Ashley WW, Wyndham CRC, Bauernfeind RA, Swiryn SP, Dhingra RC, Rosen KM: Treadmill exercise testing in the WolffParkinson-White syndrome. Am. J. Cardiol. 45: 742, 1980.PubMedCrossRefGoogle Scholar
  7. 7.
    Lévy S, Broustet JP: Exercise testing in the Wolff-Parkinson-White syndrome. Am. J. Cardiol. 48: 976, 1981.PubMedCrossRefGoogle Scholar
  8. 8.
    Wellens HJJ, Brugada P, Roy D, Weiss J, Bär FW: Effect of isoproterenol on the anterograde refractory period of the accessory pathway in patients with the Wolff-Parkinson-White syndrome. Am. J. Cardiol. 50: 180, 1982.PubMedCrossRefGoogle Scholar
  9. 9.
    Wolff L, Parkinson J, White PD: Bundle branch block with short PR interval in healthy young people prone to paroxysmal tachycardia. Am. Heart J. 5: 685, 1930.CrossRefGoogle Scholar
  10. 10.
    Lamb LE: Multiple variations of WolffParkinson-White conduction in one subject. Intermittent normal conduction and a false positive exercise tolerance test. Am. J. Cardiol. 4: 346, 1959.PubMedCrossRefGoogle Scholar
  11. 11.
    S’jongers JJ, Dirix A, Jolie P, Borms J, Segers M: Wolff-Parkinson-White syndrome and sports aptitude. J. Sports Med. 16: 6, 1976.Google Scholar
  12. 12.
    Sandberg L: The effect of exercise on the electrocardiogram of preexcitation. Acta Med. Scand. Suppl 169 (Supp 365): 88, 1961.Google Scholar
  13. Wellens HJJ: Wolff-Parkinson-White syndrome. In Cardiac Arrhythmias: From diagnosis to therapy. Levy S, Scheinman M (eds.), Futura Publishing, New-York, 1984, p. 287.Google Scholar
  14. 14.
    Crick JCP, Davies DW, Holt P, Curry PVL, Sowton E: Effect of exercise on the accessory atrio-ventricular pathway. ( Abstract.) Presented at the International Symposium on Cardiac Arrhythmias. Marseille. 1982, p. 22.Google Scholar
  15. 15.
    German LD, Gallagher JJ, Broughton A, Guarnieri T, Trantham JL: Effects of exercise and isoproterenol during atrial fibrillation in patients with Wolff-Parkinson-White Syndrome. Am. J. Cardiol. 51: 1205, 1983.CrossRefGoogle Scholar
  16. 16.
    Lévy S, Pierron JP, Eisinger JF, Franchi J, Faugère G, Valeix B, Marion J, Gérard R: Tachycardie supraventriculaire induite par l’effort et les catécholamines. Arch. Mal Coeur. 78: 1431, 1985.PubMedGoogle Scholar
  17. 17.
    Butrous GS, Nathan AW, Bexton RS, Helle-strand KJ, Camm AJ: The effect of posture and exercise on the electrophysiological properties of direct atrioventricular accessory pathways. (Abstract.) J. Am. Coll. Cardiol. 3: 612, 1984.Google Scholar
  18. 18.
    Frank R, Fontaine G, Tonet JL, Grosggeat Y: Effect of exercise on orthodromic tachycardia induction and termination by pacing. (Abstract.) JACC 3: 611, 1984.Google Scholar
  19. 19.
    Przybyliski J, Chiale PA, Halpern MS, Nau GJ, Elizari MV, Rosenbaum MB: Unmasking of ventricular preexcitation by vagal stimulation or isoproterenol administration. Circulation 61: 1030, 1980.Google Scholar
  20. 20.
    Castellanos A, Levy S, Befeler B, Myerburg RJ: Mechanism determining the ventricular rate in Wolff-Parkinson-White arrhythmias. Adv. Cardiol. 14: 221, 1975.PubMedGoogle Scholar
  21. 21.
    Denes P, Wu D, Dhingra R, Pietras R, Rosen KM: The effects of cycle length on cardiac refractory periods in man. Circulation 49: 32, 1974.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing 1986

Authors and Affiliations

  • Samuel Lévy
  • Jean-Paul Broustet
  • Marc Metge
  • Roland Cointe
  • Gérard Faugère
  • Raymond Gérard

There are no affiliations available

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