Advertisement

Autonomic tone modulation of cardiac arrhythmias

  • G. S. Butrous
Part of the Current Status of Clinical Cardiology book series (CSOCC, volume 6)

Abstract

The heart is extensively innervated by both the sympathetic and parasympathetic system. These nerves regulate both the electrical and mechanical functions of the heart and play a very important role in the stabilization of cardiac function. Disturbances in this regulatory mechanism may play an important role in the genesis of cardiac arrhythmias.

Keywords

Accessory Pathway Sick Sinus Syndrome Autonomic Tone Stellate Ganglion Block Ventricular Fibrillation Threshold 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Janes, R.D., Brandys, J. C., Hopkins, D.A., Johnstone, D.E., Murphy, D. A. and Armour, J. A. (1986). Anatomy of human extrinsic cardiac nerves and ganglia. Am. J. Cardiol., 57, 299 – 309PubMedCrossRefGoogle Scholar
  2. 2.
    Randall, W. and Armour, J. A. (1977). Gross and microscopic anatomy of the cardiac innervation. In Randall, W. (ed) Neuronal Regulation of the Heart, pp. 13– 41. ( NY: Oxford Univ. Press )Google Scholar
  3. 3.
    Randall, W., Armour, J. A., Geis, W.P. and Lippincott, D.B. (1972). Regional cardiac distribution of sympathetic nerves. Fed. Proc 1, 1199 – 203Google Scholar
  4. 4.
    Randall, W. C. and Ardell, J. L. (1985). Selective parasympathectomy of autonomic and conductile tissue of the canine heart. Am. J. Physiol., 248, H61 – H68PubMedGoogle Scholar
  5. 5.
    Brown, O.M. (1976). Cat heart acetylcholine: structural proof and distribution. Am. J. Physiol., 231, 781 – 5PubMedGoogle Scholar
  6. 6.
    Takahashi, M., Barber, M.J. and Zipes, D.P. (1985). Efferent vagal innervation of canine ventricle. Am. J. Physiol., 248, H89 – H97PubMedGoogle Scholar
  7. 7.
    Prystowsky, E. N., Jackman, W. M., Rinkenberger, R. L., Hegar, J. and Zipes, D. P. (1981). Effect of autonomic blockade on ventricular refractoriness and atrioventricular nodal conduction in humans. Circ. Res., 49, 511 – 18PubMedGoogle Scholar
  8. 8.
    Zipes, D.P., Barber, M. J., Takahashi, M. and Gilmour, R.F. (1983). Influence of the autonomic nervous system on the genesis of cardiac arrhythmia. Pacing Clin, Electrophysiol, 6, 1210 – 20CrossRefGoogle Scholar
  9. 9.
    Levy, M.N. (1971). Sympathetic-parasympathetic interaction in the heart. Circ. Res., 29, 437 – 45PubMedGoogle Scholar
  10. 10.
    Malliani, A., Schwartz, P.J. and Sanchetti, A. (1969). A sympathetic reflex elicited by experimental coronary occlusion. Am. J. Physiol., 217, 703 – 9PubMedGoogle Scholar
  11. Weiss, J. and Shine, K.I. (1982). [K+] accumulation and electrophysiological alterations during early myocardial ischemia. Am. J. Physiol., 243, H318–H327Google Scholar
  12. 12.
    Martins, J.B., Miller, M.J. and Leonard, M.T. (1985). Electrophysiologic effects due to regional sympathetic denervation supersensitivity in the dog ventricle. Circulation, 72, 111 – 41CrossRefGoogle Scholar
  13. 13.
    Kilks, B.R., Burgess, M.J. and Abildskov, J. A. (1975). Influence of sympathetic tone on ventricular fibrillation threshold during experimental coronary occlusion. Am. J. Cardiol., 36, 45 – 51CrossRefGoogle Scholar
  14. 14.
    Gillis, R.A. (1971). Role of the nervous system in the arrhythmia produced by coronary occlusion of the cat. Am. Heart J., 81, 677 – 84PubMedCrossRefGoogle Scholar
  15. 15.
    Gettes, L. S., Symanski, J. D., Flut, W. F., Johnson, T. A. and Graebner, C. (1986). The intracellular and extracellular changes associated with ischaemia — effects of catecholamines in arrhythmogenesis. Eur. Heart J. 7(Suppl A), 77 – 84PubMedGoogle Scholar
  16. 16.
    Lombardi, F. (1986). Acute myocardial ischaemia, neural reflexes and ventricular arrhythmias. Eur. Heart J., 7(Suppl A), 91 – 7PubMedGoogle Scholar
  17. 17.
    Scheridan, D.J., Penkoske, P. A., Sobel, B.E. and Corr, P. B. (1980). Alpha-adre- nergic contributions to dysrhythmias during myocardial ischaemia and reperfusion in cats. J. Clin. Invest., 65, 161 – 71CrossRefGoogle Scholar
  18. 18.
    Corr, P. B., Shayman, J. A., Kramer, J. B. and Kipnis, R. J. (1981). Increased alpha- adrenergic receptors in ischaemic cat myocardium: A potential mediator of electrophysiological derangements. J. Clin. Invest., 67, 1232 – 6PubMedCrossRefGoogle Scholar
  19. 19.
    Yamada, K. A., Saffitz, J. E. and Corr, P. B. (1986). Role of alpha and beta-adrenergic receptor stimulation in the genesis of arrhythmias during myocardial ischaemia. Eur. Heart J., 7(Suppl A), 85 – 90PubMedGoogle Scholar
  20. 20.
    Katz, C., Martin, R. D., Landa, B. and Chadda, K.D. (1985). Relationship of psychologic factors to frequent symptomatic ventricular arrhythmias. Am. J. Med., 78, 589 – 94PubMedCrossRefGoogle Scholar
  21. Tavazzi, L., Zotti, A.M. and Rondanelli, R. (1986). The role of psychologic stress in the genesis of lethal arrhythmias in patients with coronary artery disease. Eur. Heart J. (Suppl A), 99 – 106Google Scholar
  22. 22.
    Rowey, P. R., Verrier, R.I. and Lown, B. (1982). Decreased vulnerability to ventricular fibrillation by vasodilator-induced baroreceptor sensitisation. Cardiov. Res., 17, 106 – 12Google Scholar
  23. 23.
    Schwartz, P. J., La Rovere, M. T., Zaza, A., Pala, M., Mazzoleni, C. and Specchia, G. (1985). Baroreceptive reflexes and cardiac electrical instability in patients with a myocardial infarction. New Trends in Arrhythmias, 11, 289 – 92Google Scholar
  24. Schwartz, P. J. and Stone, H. L. (1985). The analysis and modulation of autonomic reflexes in the prediction and prevention of sudden death. In Zipes, D. and Jalife, J. (eds.) Cardiac Electrophysiology and Arrhythmias, pp. 167–76 (NY: Grune 6c Stratton)Google Scholar
  25. 25.
    Ewing, D.J., Neilson, J.M.M. and Travis, P. (1984). New method for assessing cardiac parasympathetic activity using 24 hour electrocardiograms. Br. Heart J., 52, 396 – 02PubMedCrossRefGoogle Scholar
  26. 26.
    Magid, N. M., Martin, G. J., Kehoe, R. F., Zheutlin, T. A. et al. (1985). Diminished heart rate variability in sudden cardiac death. Circulation, 72, (Suppl. lll), 241Google Scholar
  27. 27.
    Kilman, B. S., Verrier, R. L. and Lown, B. (1976). Effects of vagus stimulation upon excitability of the canine ventricle. Am. J. Cardiol., 37, 1041 – 5CrossRefGoogle Scholar
  28. 28.
    Singh, B.N. and Venkatesh, N. (1984). Prevention of myocardial reinfarction and sudden death in survivors of acute myocardial infarction: role of prophylactic beta adrenoceptor blockade. Am. Heart. J., 107, 189 – 200PubMedCrossRefGoogle Scholar
  29. 29.
    Norwegian Multicentre Study Group (1981). Timolol induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N. Engl. J. Med., 304, 801 – 7CrossRefGoogle Scholar
  30. 30.
    Campbell, R. W.F. and Bourke, J. (1986). Beta blocking agents in post myocardial infarction patients. Eur. Heart J., 7(Suppl A), 119 – 21PubMedGoogle Scholar
  31. 31.
    De Marneffe, M., Jacobs, P., Haardt, R. and Englert, M. (1986). Variations of normal sinus node function in relation to age: role of autonomic influence. Eur. Heart J., 7, 662 – 72PubMedGoogle Scholar
  32. 32.
    Sethi, K.K., Jaishankar, S., Balachander, J., Bahl, V. K. and Gupta, M.P. (1984). Sinus node function after autonomic blockade in normals and in Sick Sinus syndrome. Int. J. Cardiol., 5, 707 – 19PubMedCrossRefGoogle Scholar
  33. 33.
    Ambrosini, F. A., Bertoni, T., Pagnoni, F., Pupilella, T. and Lotto, A. (1985). Has carotid sinus compression any relationship with sinus node function correlations with the stimulation tests? New Trends in Arrhythmias, 2, 123 – 6Google Scholar
  34. 34.
    Salata, J. J., Gill, R.M., Gilmour, R.F. and Zipes, D.P. (1986). Effects of sympathetic tone on vagally induced phasic changes in heart rate and atrioventricular node conduction in the anaesthetized dog. Circ. Res., 58, 584 – 94PubMedGoogle Scholar
  35. 35.
    Butrous, G. S., Cochrane, T. and Camm, A.J. (1987). Rapid autonomic tone regulation of atrioventricular node conduction in man. Am. Heart J., 113, 934 – 40PubMedCrossRefGoogle Scholar
  36. 36.
    Paparella, N., Alboni, P., Pirani, R., Cappato, R., Thomasi, A. M. and Masoni, A. (1986). Effects of autonomic blockade on dual atrioventricular nodal pathways pattern. J. Electrocardiol., 19, 269 – 74PubMedCrossRefGoogle Scholar
  37. 37.
    Schwartz, P.J. (1985). Idiopathic long QT syndrome: progress and questions. Am. Heart. J., 109, 399 – 410PubMedCrossRefGoogle Scholar
  38. 38.
    Cinca, J., Evangelista, A., Montoyo, J., Barutell, C., Figueras, J., Valle, V., Rius, J. and Soler-Soler, J. (1985). Electrophysiologic effects of unilateral right and left stellate ganglion block on the human heart. Am. Heart J., 109, 46 – 54PubMedCrossRefGoogle Scholar
  39. 39.
    Vincent, G.M. (1985). The heart rate of Romano-Ward long QT patients. Circulation, 72, 111 – 44Google Scholar
  40. 40.
    Wellens, H.J. J., Burgada, P., Roy, D., Weiss, J. and Bar, F. W. (1982). Effect of isoproterenol on the anterograde refractory pathway in patients with Wolff- Parkinson-White syndrome. Am. J. Cardiol., 50, 180 – 4PubMedCrossRefGoogle Scholar
  41. 41.
    Butrous, G.S., Nathan, A.W., Bexton, R.S., Hellestrand, K.J. and Camm, A.J. (1984). The effect of posture and exercise on the electrophysiological properties of direct atrioventricular accessory pathway. J. Am. Coll. Cardiol., 3, 612Google Scholar
  42. 42.
    Brugada, P., Facchini, M., and Wellens, H. J. J. (1986). Effects of isoproterenol and amiodarone and the role of exercise in initiation of circus movement tachycardia in the accessory atrioventricular pathway. Am. J. Cardiol., 57, 146 – 9PubMedCrossRefGoogle Scholar
  43. 43.
    Averill, K.H., Fismoer, R.J. and Lamb, L.E. (1960) Electrocardiographic findings in 67375 asymptomatic subjects: IV Wolff-Parkinson-White syndrome. Am. J. Cardiol., 6, 108 – 29PubMedCrossRefGoogle Scholar
  44. 44.
    Khair, G. Z., Tristani, F.E. and Bamrah, V. S. (1983). Dynamic QRS variations in Wolff-Parkinson-White syndrome: electrocardiograph and clinical observation. Am. Heart J., 105, 878 – 82PubMedCrossRefGoogle Scholar
  45. 45.
    Duthie, R.J. (1946). Mechanism of the Wolff-Parkinson-White syndrome. Br. Heart J. 8, 96 – 102CrossRefGoogle Scholar
  46. 46.
    Wolff, G.S., Han, J. and Curran, J. (1978). Wolff-Parkinson-White syndrome in neonate. Am. J. Cardiol., 41, 559 – 63PubMedCrossRefGoogle Scholar
  47. 47.
    Przybylski, J., Chiale, P. A., Halpern, M. S., Nau, G. J., Elizari, M. V. and Rosen- baum, M. B. (1980). Unmasking of ventricular pre-excitation of vagal stimulation of isoproterenol administration. Circulation, 61, 1030 – 7PubMedGoogle Scholar
  48. 48.
    Gavrilescu, S. (1976). Manifestation of the Wolff-Parkinson-White syndrome during isoprenaline infusion and carotid sinus massage. Cardiology, 61, 146 – 9PubMedCrossRefGoogle Scholar
  49. Butrous, G.S., Kaye, G.C., Nathan, A.W., Banim, S. O. and Camm, A.J. (1984). Respiratory modulation of atrioventricular accessory pathway conduction. Circulation, 70, II, 217Google Scholar
  50. 50.
    Rosenberg, M. J., Eugene Uretz, M.S. and Denes, P. (1983). Sleep and ventricular arrhythmias. Am. Heart J., 106, 703 – 9PubMedCrossRefGoogle Scholar
  51. 51.
    Otsuka, K. (1980). Studies of digitalis induced arrhythmias by recordings of 24 hour continuous electrocardiograms. Fukuoka Igaku Zasshi, 71, 631 – 44PubMedGoogle Scholar
  52. 52.
    Otsuka, K., Vanaga, T., Ichimaru, Y. and Seto, K. (1982). Sleep and night-type arrhythmias. Jpn Heart J. 23, 479 – 85PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • G. S. Butrous

There are no affiliations available

Personalised recommendations