[The effects of pharmacological autonomic blockade on the conduction system in patients with and without sinus node dysfunction].
Electrophysiological studies were performed in 26 patients with sick sinus syndrome (SSS) and 12 controls before and after pharmacologic autonomic blockade (PAB) with propranolol (0.15 mg/kg) and atropine (0.04 mg/kg). Sinus cycle length (SCL) shortened significantly after PAB in both groups. PA and HV intervals did not change after PAB. AH interval shortened and Wenckebach period increased after PAB in SSS group. Maximum corrected sinus node recovery time shortened in the control group but did not change in the SSS group after PAB. Calculated sinoatrial conduction time shortened after PAB in both groups. Refractory periods of the atrioventricular (AV) node and the ventricle shortened significantly, but those of the atrium did not change after PAB. Linear relations existed between the change of SCL and the change of AH interval and of the Wenckebach period. These results suggested that the autonomic nervous system had the same effects on the sinus and the AV nodes in patients with SSS, and that parasympathetic tone was predominant on the sinus node, the perinodal tissue and the AV node under resting conditions.
Tsuchioka
Y
Y
First Department of Internal Medicine, Hiroshima University School of Medicine.
Shimizu
W
W
Karakawa
S
S
Mukai
J
J
Nagata
K
K
Yamagata
T
T
Okamoto
M
M
Matuura
H
H
Kajiyama
G
G
D001285:Atropine / Q000494:pharmacology*; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000503:physiopathology; D004594:Electrophysiology; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000494:pharmacology*; D012032:Refractory Period, Electrophysiological / Q000187:drug effects; D012804:Sick Sinus Syndrome / Q000188:drug therapy / Q000503:physiopathology*
D001285:Atropine; D011433:Propranolol