Comparative effects of adenosine triphosphate on accessory pathway and atrioventricular nodal conduction.
Identifieur interne : 004B53 ( Main/Exploration ); précédent : 004B52; suivant : 004B54Comparative effects of adenosine triphosphate on accessory pathway and atrioventricular nodal conduction.
Auteurs : C. Rinne [Canada] ; A D Sharma ; G J Klein ; R. Yee ; T. SzaboSource :
- American heart journal [ 0002-8703 ] ; 1988.
English descriptors
- KwdEn :
- Adenosine Triphosphate (pharmacology), Adult, Atrioventricular Node (drug effects), Cardiac Pacing, Artificial, Electrocardiography, Electrophysiology, Heart Conduction System (drug effects), Humans, Propranolol, Time Factors, Verapamil, Wolff-Parkinson-White Syndrome (diagnosis), Wolff-Parkinson-White Syndrome (physiopathology).
- MESH :
- chemical , pharmacology : Adenosine Triphosphate.
- diagnosis : Wolff-Parkinson-White Syndrome.
- drug effects : Atrioventricular Node, Heart Conduction System.
- physiopathology : Wolff-Parkinson-White Syndrome.
- Adult, Cardiac Pacing, Artificial, Electrocardiography, Electrophysiology, Humans, Propranolol, Time Factors, Verapamil.
Abstract
Adenosine triphosphate (ATP) has potent negative dromotropic effects on the atrioventricular (AV) node, but variable effects on accessory pathway conduction have been described. The effects of an intravenous bolus injection of 8 mg ATP on accessory pathway and AV nodal conduction were determined during electrophysiologic testing with controlled atrial and ventricular rates. AV conduction was monitored during atrial or ventricular pacing at a constant cycle length, 30 msec longer than the cycle length at which block occurred. During atrial pacing antegrade block after administration of ATP occurred in 1 of 30 (3.2%) patients with accessory pathway conduction and 12 of 13 (92%) patients with AV nodal conduction (p less than 0.001). During ventricular pacing only 5 of 26 (16%) patients had accessory pathways blocked, whereas 25 of 35 (71%) patients with AV nodal conduction had block (p less than 0.001). Thus, failure of ATP to produce ventriculoatrial block identified the presence of an accessory pathway with a sensitivity of 84%, specificity of 71%, and predictive value of 72%. There was no correlation between accessory pathway properties and the effects of ATP. The effects of ATP on the AV node were concordant with the effects of a combination of verapamil and propranolol in 21 of 23 patients, suggesting that this dose ATP is an equipotent AV nodal blocker with a short duration of action. Thus, although the effects of ATP on accessory pathways and the AV node differ, block in ventriculoatrial conduction after administration of ATP cannot be used as the sole criterion to distinguish the mechanism of conduction.
PubMed: 3364337
Affiliations:
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Yee</name></author><author><name sortKey="Szabo, T" sort="Szabo, T" uniqKey="Szabo T" first="T" last="Szabo">T. Szabo</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1988">1988</date><idno type="RBID">pubmed:3364337</idno><idno type="pmid">3364337</idno><idno type="wicri:Area/PubMed/Corpus">001C61</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001C61</idno><idno type="wicri:Area/PubMed/Curation">001C61</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001C61</idno><idno type="wicri:Area/PubMed/Checkpoint">001C61</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001C61</idno><idno type="wicri:Area/Ncbi/Merge">002343</idno><idno type="wicri:Area/Ncbi/Curation">002343</idno><idno type="wicri:Area/Ncbi/Checkpoint">002343</idno><idno type="wicri:doubleKey">0002-8703:1988:Rinne C:comparative:effects:of</idno><idno type="wicri:Area/Main/Merge">005531</idno><idno type="wicri:Area/Main/Curation">004B53</idno><idno type="wicri:Area/Main/Exploration">004B53</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Comparative effects of adenosine triphosphate on accessory pathway and atrioventricular nodal conduction.</title><author><name sortKey="Rinne, C" sort="Rinne, C" uniqKey="Rinne C" first="C" last="Rinne">C. Rinne</name><affiliation wicri:level="1"><nlm:affiliation>University Hospital, London, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>University Hospital, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Sharma, A D" sort="Sharma, A D" uniqKey="Sharma A" first="A D" last="Sharma">A D Sharma</name></author><author><name sortKey="Klein, G J" sort="Klein, G J" uniqKey="Klein G" first="G J" last="Klein">G J Klein</name></author><author><name sortKey="Yee, R" sort="Yee, R" uniqKey="Yee R" first="R" last="Yee">R. Yee</name></author><author><name sortKey="Szabo, T" sort="Szabo, T" uniqKey="Szabo T" first="T" last="Szabo">T. Szabo</name></author></analytic><series><title level="j">American heart journal</title><idno type="ISSN">0002-8703</idno><imprint><date when="1988" type="published">1988</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adenosine Triphosphate (pharmacology)</term><term>Adult</term><term>Atrioventricular Node (drug effects)</term><term>Cardiac Pacing, Artificial</term><term>Electrocardiography</term><term>Electrophysiology</term><term>Heart Conduction System (drug effects)</term><term>Humans</term><term>Propranolol</term><term>Time Factors</term><term>Verapamil</term><term>Wolff-Parkinson-White Syndrome (diagnosis)</term><term>Wolff-Parkinson-White Syndrome (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Adenosine Triphosphate</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Atrioventricular Node</term><term>Heart Conduction System</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cardiac Pacing, Artificial</term><term>Electrocardiography</term><term>Electrophysiology</term><term>Humans</term><term>Propranolol</term><term>Time Factors</term><term>Verapamil</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Adenosine triphosphate (ATP) has potent negative dromotropic effects on the atrioventricular (AV) node, but variable effects on accessory pathway conduction have been described. The effects of an intravenous bolus injection of 8 mg ATP on accessory pathway and AV nodal conduction were determined during electrophysiologic testing with controlled atrial and ventricular rates. AV conduction was monitored during atrial or ventricular pacing at a constant cycle length, 30 msec longer than the cycle length at which block occurred. During atrial pacing antegrade block after administration of ATP occurred in 1 of 30 (3.2%) patients with accessory pathway conduction and 12 of 13 (92%) patients with AV nodal conduction (p less than 0.001). During ventricular pacing only 5 of 26 (16%) patients had accessory pathways blocked, whereas 25 of 35 (71%) patients with AV nodal conduction had block (p less than 0.001). Thus, failure of ATP to produce ventriculoatrial block identified the presence of an accessory pathway with a sensitivity of 84%, specificity of 71%, and predictive value of 72%. There was no correlation between accessory pathway properties and the effects of ATP. The effects of ATP on the AV node were concordant with the effects of a combination of verapamil and propranolol in 21 of 23 patients, suggesting that this dose ATP is an equipotent AV nodal blocker with a short duration of action. Thus, although the effects of ATP on accessory pathways and the AV node differ, block in ventriculoatrial conduction after administration of ATP cannot be used as the sole criterion to distinguish the mechanism of conduction.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Klein, G J" sort="Klein, G J" uniqKey="Klein G" first="G J" last="Klein">G J Klein</name><name sortKey="Sharma, A D" sort="Sharma, A D" uniqKey="Sharma A" first="A D" last="Sharma">A D Sharma</name><name sortKey="Szabo, T" sort="Szabo, T" uniqKey="Szabo T" first="T" last="Szabo">T. Szabo</name><name sortKey="Yee, R" sort="Yee, R" uniqKey="Yee R" first="R" last="Yee">R. Yee</name></noCountry><country name="Canada"><noRegion><name sortKey="Rinne, C" sort="Rinne, C" uniqKey="Rinne C" first="C" last="Rinne">C. Rinne</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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