Skip to main content

Premature Atrial Stimulation for Evaluation of Sinoatrial Conduction in Man

  • Conference paper
Cardiac Pacing

Abstract

Recent interest in the pathophysiology of sinus node dysfunction has stimulated the development of techniques that would provide a means of quantitating disturbances of sinoatrial conduction and sinus node automati-city in this group of patients [3, 6, 7, 8, 10, 11, 14, 15, 18, 20, 23, 25, 28, 30]. Such information might be useful not only in the understanding of the underlying pathophysiology but might also provide some insight into the mechanism(s) by which cardioactive agents depress sinus node function. A lack of such knowledge undoubtedly contributes to our empiricism in the selection of safe pharmacologic agents for use in these patients. One such example is the effects of digitalis in patients with sick sinus syndrome. Greenwood and Finkelstein in a review of the literature stated that 22% of all reported instances of sinoatrial (SA) block were due to digitalis excess [9]. It would not be unreasonable to assume that digitalis would cause SA block in a large number of patients with sinus node dysfunction, yet, except for the occasional patient with sinus node dysfunction [16], most of these patients tolerate digitalis remarkably well [6]. Another such example relates to the effects of quinidine and procainamide in patients with the bradycardia-tachycardia syndrome. Short reported on the markedly depressant effect of these drugs in his patients [24].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bonke, F. I. M., Bouman, L. N., Schopman, F. J. G.: Effect of an early atrial premature beat on activity of the sinoatrial node and atrial rhythm in the rabbit. Circulat. Res. 29, 704 (1971)

    PubMed  CAS  Google Scholar 

  2. Bonke, F. I. M., Bouman, L. N., Van Rijn, H. E.: Change of cardiac rhythm in the rabbit after an atrial premature beat. Circulat. Res. 24, 533 (1969)

    PubMed  CAS  Google Scholar 

  3. Dighton, D. H.: Sinus bradycardia: Autonomic influences and clinical assessment. Brit. Heart J. 36, 791 (1974)

    Article  PubMed  CAS  Google Scholar 

  4. Dhingra, R. C., Amat-Y-Leon, F., Wyndham, C., Wu, D., Denes, P., Rosen, K. M.: The electrophysiological effects of ouabain on sinus node and atrium in man. J. clin. Invest. 56, 555 (1975)

    Article  PubMed  CAS  Google Scholar 

  5. Eccles, H. C., Hoff, H. E.: The rhythm of the heart beat. II. Disturbance of rhythm produced by late premature beats. Proc. roy. Soc. B 115, 327 (1934)

    Article  Google Scholar 

  6. Engel, T. R., Schaal, S. F.: Digitalis in the sick sinus syndrome: The effects on sinoatrial automaticity and atrioventricular conduction. Circulation 48, 1201 (1973)

    PubMed  CAS  Google Scholar 

  7. Ferrer, M. L: The sick sinus syndrome. Circulation 47, 635 (1973)

    PubMed  CAS  Google Scholar 

  8. Goldreyer, B. N., Damato, A. N.: Sinoatrial node entrance block. Circulation 44, 789 (1971)

    PubMed  CAS  Google Scholar 

  9. Greenwood, R. J., Finkelstein, D.: Sinoatrial Heart Block. Springfield, Ill.: Charles C. Thomas, 1964, p. 37

    Google Scholar 

  10. Gupta, P. K., Lichstein, E., Chadda, K. D., Badui, E.: Appraisal of sinus nodal recovery time in patients with sick sinus syndrome. Amer. J. Cardiol. 34, 265 (1974)

    Article  PubMed  CAS  Google Scholar 

  11. Kaplan, B. M., Langendorf, R., Lev, M., Pick, A.: Tachycardia-bradycardia syndrome (so-called “Sick Sinus Syndrome”). Amer. J. Cardiol. 31, 497 (1973)

    Article  PubMed  CAS  Google Scholar 

  12. Klein, H., Singer, D. H., Hoffman, B. F.: Effects of atrial premature systoles on sinus rhythm in the rabbit. Circulat. Res. 32, 480 (1973)

    PubMed  CAS  Google Scholar 

  13. Langendorf, R., Lesser, M. E., Plotkin, P., Levin, B. D.: Atrial parasystole with interpolation. Observations on prolonged sinoatrial conduction. Amer. Heart J. 63, 649 (1962)

    Article  PubMed  CAS  Google Scholar 

  14. Mandel, W., Hayakawa, H., Danzig, R., Marcus, H. S.: Evaluation of sinoatrial node function in man by overdrive suppression. Circulation 44, 59 (1971)

    PubMed  CAS  Google Scholar 

  15. Mandel, W. J., Hayakawa, H., Hirokazu, A., Allen, H. N., Danzig, R., Kermaier, A. L: Assessment of sinus node function in patients with the sick sinus syndrome. Circulation 46,761(1972)

    PubMed  CAS  Google Scholar 

  16. Margolis, J. R., Strauss, H. C., Miller, H. C., Gilbert, M., Wallace, A. G.: Digitalis and the sick sinus syndrome. Circulation 52, 162 (1975)

    PubMed  CAS  Google Scholar 

  17. Miller, H. C., Strauss, H. C.: Measurement of sinoatrial conduction time by premature atrial stimulation in the rabbit. Circulat. Res. 35, 935 (1974)

    PubMed  CAS  Google Scholar 

  18. Narula, O. S., Samet, P., Javier, R. P.: Significance of the sinus node recovery time. Circulation 45, 140 (1972)

    PubMed  CAS  Google Scholar 

  19. Paes de Carvalho, A., de Mello, W. C., Hoffman, B. F.: Electrophysiological evidence for specialized fiber types in rabbit atrium. Amer. J. Physiol. 196, 483 (1959)

    Google Scholar 

  20. Rosen, K. M., Loeb, H. S., Sinno, M. Z., Rahimtoola, S. H., Gunnar, R. M.: Cardiac conduction in patients with symptomatic sinus node disease. Circulation 43, 836 (1971)

    PubMed  CAS  Google Scholar 

  21. Reiffel, J. A., Bigger, J. T., Jr., Konstam, M. A.: The relationship between sinoatrial conduction time and sinus cycle length during spontaneous sinus arrhythmia in adults. Circulation 50, 924 (1974)

    PubMed  CAS  Google Scholar 

  22. Sano, T., Yamagishi, S.: Spread of excitation from the sinus node. Circulat. Res. 16, 423 (1965)

    PubMed  CAS  Google Scholar 

  23. Seipel, L., Breithardt, A., Both, A., Loogen, F.: Messung der sinu-atrialen Leitungszeit mittels vorzeitiger Vorhofstimulation beim Menschen. Dtsch. med. Wschr. 99, 1895 (1974)

    Article  PubMed  CAS  Google Scholar 

  24. Short, D. S.: The syndrome of alternating bradycardia and tachycardia. Brit. Heart J. 16, 208 (1954)

    Article  PubMed  CAS  Google Scholar 

  25. Sims, B. A.: Pathogenesis of atrial arrhythmias. Brit. Heart J. 34, 336 (1972)

    Article  PubMed  CAS  Google Scholar 

  26. Strauss, H. C., Bigger, J. T., Jr.: The electrophysiological properties of the rabbit sinoatrial perinodal fibers. Circulat. Res. 31, 490 (1972)

    PubMed  CAS  Google Scholar 

  27. Strauss, H. C., Wallace, A. G.: Direct and indirect techniques in the evaluation of sinus node functions. In: The Conduction System of the Heart. Structure, Function, and Clinical Implications, Wellens, H. J. J., Lie, K. I., Janse, M. J. (ed.). Leiden, H. E. Stenfert Kroese B. V. 1976, p. 227

    Google Scholar 

  28. Strauss, H. C., Bigger, J. T., Jr., Saroff, A. L., Giardina, E. G. V.: Electrophysiologic evaluation of sinus node function in patients with sinus node dysfunction. Circulation 53, 763 (1976)

    PubMed  CAS  Google Scholar 

  29. Strauss, H. C., Gilbert, M., Svenson, R. H., Miller, H. C., Wallace, A. G.: Electrophysiological effects of propranolol on sinus node function in patients with sinus node dysfunction. Submitted for publication

    Google Scholar 

  30. Strauss, H. C., Saroff, A. L., Bigger, J. T., Jr., Giardina, E. G. V.: Premature atrial stimulation as a key to the understanding of sinoatrial conduction in man. Circulation 47, 86 (1973)

    PubMed  CAS  Google Scholar 

  31. Ticzon, A. R., Strauss, H. C., Gallagher, J. J., Wallace, A. G.: Sinus node function in the intact dog heart evaluated by premature atrial stimulation and atrial pacing. Amer. J. Cardiol. 35, 492 (1975)

    Article  PubMed  CAS  Google Scholar 

  32. Wenckebach, K. F.: Über die Dauer der compensatorischen Pause nach Reizung der Vorkammer des Säugetierherzens. Arch. Anat. Physiol. (Physiol. Abt.) 57, 1903

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1976 Springer-Verlag Berlin · Heidelberg

About this paper

Cite this paper

Strauss, H.C., Wallace, A.G. (1976). Premature Atrial Stimulation for Evaluation of Sinoatrial Conduction in Man. In: Lüderitz, B. (eds) Cardiac Pacing. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66356-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-66356-7_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-66358-1

  • Online ISBN: 978-3-642-66356-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics