Effect of Isoproterenol on Accessory Pathways Without Overt Retrograde Conduction
Identifieur interne : 004053 ( Main/Exploration ); précédent : 004052; suivant : 004054Effect of Isoproterenol on Accessory Pathways Without Overt Retrograde Conduction
Auteurs : Huagui G. Li [Canada] ; Raymond Yee [Canada] ; George J. Klein [Canada]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1995-03.
English descriptors
Abstract
Effect of Isoproterenol on Accessory Pathways. Introduction: Absence of overt retrograde accessory pathway conduction may be related to low resting sympathetic tone in patients with apparent unidirectional anterogradely conducting accessory pathways (UACAP). Methods and Results: To test this hypothesis, we studied the effect of isoproterenol on accessory pathway function and tachycardia induction in 18 patients (12 men and 6 women, ages 34 ± 16 years [mean ± SD]) with UACAP. After baseline study in the drug‐free state, electrophysiologic testing was repeated during infusion of isoproterenol (0.5 to 1.5 μg/min, titrated to increase heart rate by 20%). Isoproterenol shortened the anterograde effective refractory period (398 ± 117 vs 305 ± 63 msec; P < 0.01; basic drive cycle length 600 msec) of the accessory pathway. However, retrograde accessory pathway conduction and atrioventricular reentrant tachycardia were exposed in only 3 (17%) patients by isoproterenol infusion. All 3 patients with retrograde accessory pathway revealed after isoproterenol had clinically documented tachycardia (supraventricular tachycardia in 2, atrial fibrillation in 1) during exercise, while none of the patients with persistent absence of retrograde accessory pathway conduction had this symptom. Conclusions: We conclude that absence of overt retrograde conduction over accessory pathways may be related to low resting sympathetic tone in some individuals. Restoration of retrograde conduction with isoproterenol is unusual and most likely to be observed in patients with clinically documented paroxysmal supraventricular tachycardia related to exercise.
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DOI: 10.1111/j.1540-8167.1995.tb00768.x
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Li</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1995-03">1995-03</date><biblScope unit="volume">6</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="170">170</biblScope><biblScope unit="page" to="173">173</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">4C5F8EA5E155985A3E82BC53456D01C810FB67D6</idno><idno type="DOI">10.1111/j.1540-8167.1995.tb00768.x</idno><idno type="ArticleID">JCE170</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>isoproterenol</term><term>retrograde accessory pathway conduction</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Effect of Isoproterenol on Accessory Pathways. Introduction: Absence of overt retrograde accessory pathway conduction may be related to low resting sympathetic tone in patients with apparent unidirectional anterogradely conducting accessory pathways (UACAP). Methods and Results: To test this hypothesis, we studied the effect of isoproterenol on accessory pathway function and tachycardia induction in 18 patients (12 men and 6 women, ages 34 ± 16 years [mean ± SD]) with UACAP. After baseline study in the drug‐free state, electrophysiologic testing was repeated during infusion of isoproterenol (0.5 to 1.5 μg/min, titrated to increase heart rate by 20%). Isoproterenol shortened the anterograde effective refractory period (398 ± 117 vs 305 ± 63 msec; P < 0.01; basic drive cycle length 600 msec) of the accessory pathway. However, retrograde accessory pathway conduction and atrioventricular reentrant tachycardia were exposed in only 3 (17%) patients by isoproterenol infusion. All 3 patients with retrograde accessory pathway revealed after isoproterenol had clinically documented tachycardia (supraventricular tachycardia in 2, atrial fibrillation in 1) during exercise, while none of the patients with persistent absence of retrograde accessory pathway conduction had this symptom. Conclusions: We conclude that absence of overt retrograde conduction over accessory pathways may be related to low resting sympathetic tone in some individuals. Restoration of retrograde conduction with isoproterenol is unusual and most likely to be observed in patients with clinically documented paroxysmal supraventricular tachycardia related to exercise.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Li, Huagui G" sort="Li, Huagui G" uniqKey="Li H" first="Huagui G." last="Li">Huagui G. Li</name></noRegion><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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