Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation
Identifieur interne : 000178 ( Main/Corpus ); précédent : 000177; suivant : 000179Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation
Auteurs : Pablo Denes ; James M. Cummings ; Ross Simpson ; Delon Wu ; Fernando Amat-Y-Leon ; Ramesh Dhingra ; Kenneth M. RosenSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1977.
Abstract
Electrophysiologic effects of intravenous propranolol, 0.1 mg/kg, were evaluated in 18 patients with anomalous pathways utilizing intracardiac stimulation and recording. Fourteen patients had Wolff-Parkinson-White syndrome and four had concealed ventricular preexcitation. Anomalous pathway effective refractory period could be measured during the control period and after propranolol administration in nine patients and was 304 ± 7.5 (mean ± standard error of the mean) and 304 ± 8.3 msec, respectively (difference not significant). Ventricular paced 1:1 ventriculoatrial (V-A) conduction (reflecting retrograde anomalous pathway conduction) measured in 12 patients was intact during both the control period and after propranolol at rates of 170 to 200/min. Sustained paroxysmal supraventricular tachycardia was induced in 14 patients during the control period and in 10 after propranolol (in 4 of whom the tachycardia could not be sustained because of atrioventricular [A-V] nodal refractoriness). Mean cycle length of tachycardia in these 10 patients was 328 ± 18 (control) and 352 ± 19 msec (propranolol) (P < 0.01). The increase in tachycardia cycle length reflected an increase in A-V nodal conduction time (A-H interval).In conclusion: (1) Propranolol has an insignificant effect on both anterograde and retrograde anomalous pathway properties. (2) In most cases, propranolol does not interfere with induction of sustained circus movement tachycardia. However, it does produce a statistically significant but slight slowing of the rate of tachycardia. (3) In a minority of cases, propranolol inhibits induction of sustained paroxysmal supraventricular tachycardia by increasing A-V nodal refractoriness.
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DOI: 10.1016/0002-9149(78)90858-5
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Cummings</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Simpson, Ross" sort="Simpson, Ross" uniqKey="Simpson R" first="Ross" last="Simpson">Ross Simpson</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Wu, Delon" sort="Wu, Delon" uniqKey="Wu D" first="Delon" last="Wu">Delon Wu</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Amat Y Leon, Fernando" sort="Amat Y Leon, Fernando" uniqKey="Amat Y Leon F" first="Fernando" last="Amat-Y-Leon">Fernando Amat-Y-Leon</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Dhingra, Ramesh" sort="Dhingra, Ramesh" uniqKey="Dhingra R" first="Ramesh" last="Dhingra">Ramesh Dhingra</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Rosen, Kenneth M" sort="Rosen, Kenneth M" uniqKey="Rosen K" first="Kenneth M." last="Rosen">Kenneth M. Rosen</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB</idno><date when="1978" year="1978">1978</date><idno type="doi">10.1016/0002-9149(78)90858-5</idno><idno type="url">https://api.istex.fr/document/5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000178</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</title><author><name sortKey="Denes, Pablo" sort="Denes, Pablo" uniqKey="Denes P" first="Pablo" last="Denes">Pablo Denes</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Cummings, James M" sort="Cummings, James M" uniqKey="Cummings J" first="James M." last="Cummings">James M. Cummings</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Simpson, Ross" sort="Simpson, Ross" uniqKey="Simpson R" first="Ross" last="Simpson">Ross Simpson</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Wu, Delon" sort="Wu, Delon" uniqKey="Wu D" first="Delon" last="Wu">Delon Wu</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Amat Y Leon, Fernando" sort="Amat Y Leon, Fernando" uniqKey="Amat Y Leon F" first="Fernando" last="Amat-Y-Leon">Fernando Amat-Y-Leon</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Dhingra, Ramesh" sort="Dhingra, Ramesh" uniqKey="Dhingra R" first="Ramesh" last="Dhingra">Ramesh Dhingra</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author><author><name sortKey="Rosen, Kenneth M" sort="Rosen, Kenneth M" uniqKey="Rosen K" first="Kenneth M." last="Rosen">Kenneth M. Rosen</name><affiliation><mods:affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977">1977</date><biblScope unit="volume">41</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1061">1061</biblScope><biblScope unit="page" to="1067">1067</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB</idno><idno type="DOI">10.1016/0002-9149(78)90858-5</idno><idno type="PII">0002-9149(78)90858-5</idno><idno type="ArticleID">78908585</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Electrophysiologic effects of intravenous propranolol, 0.1 mg/kg, were evaluated in 18 patients with anomalous pathways utilizing intracardiac stimulation and recording. Fourteen patients had Wolff-Parkinson-White syndrome and four had concealed ventricular preexcitation. Anomalous pathway effective refractory period could be measured during the control period and after propranolol administration in nine patients and was 304 ± 7.5 (mean ± standard error of the mean) and 304 ± 8.3 msec, respectively (difference not significant). Ventricular paced 1:1 ventriculoatrial (V-A) conduction (reflecting retrograde anomalous pathway conduction) measured in 12 patients was intact during both the control period and after propranolol at rates of 170 to 200/min. Sustained paroxysmal supraventricular tachycardia was induced in 14 patients during the control period and in 10 after propranolol (in 4 of whom the tachycardia could not be sustained because of atrioventricular [A-V] nodal refractoriness). Mean cycle length of tachycardia in these 10 patients was 328 ± 18 (control) and 352 ± 19 msec (propranolol) (P < 0.01). The increase in tachycardia cycle length reflected an increase in A-V nodal conduction time (A-H interval).In conclusion: (1) Propranolol has an insignificant effect on both anterograde and retrograde anomalous pathway properties. (2) In most cases, propranolol does not interfere with induction of sustained circus movement tachycardia. However, it does produce a statistically significant but slight slowing of the rate of tachycardia. (3) In a minority of cases, propranolol inhibits induction of sustained paroxysmal supraventricular tachycardia by increasing A-V nodal refractoriness.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Pablo Denes MD, FACC</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item><json:item><name>James M. Cummings MD, FACC</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item><json:item><name>Ross Simpson MD</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item><json:item><name>Delon Wu MD, FACC</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item><json:item><name>Fernando Amat-Y-leon MD, FACC</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item><json:item><name>Ramesh Dhingra MD, FACC</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item><json:item><name>Kenneth M. Rosen MD, FACC</name><affiliations><json:string>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</json:string></affiliations></json:item></author><articleId><json:string>78908585</json:string></articleId><language><json:string>eng</json:string></language><abstract>Electrophysiologic effects of intravenous propranolol, 0.1 mg/kg, were evaluated in 18 patients with anomalous pathways utilizing intracardiac stimulation and recording. Fourteen patients had Wolff-Parkinson-White syndrome and four had concealed ventricular preexcitation. Anomalous pathway effective refractory period could be measured during the control period and after propranolol administration in nine patients and was 304 ± 7.5 (mean ± standard error of the mean) and 304 ± 8.3 msec, respectively (difference not significant). Ventricular paced 1:1 ventriculoatrial (V-A) conduction (reflecting retrograde anomalous pathway conduction) measured in 12 patients was intact during both the control period and after propranolol at rates of 170 to 200/min. Sustained paroxysmal supraventricular tachycardia was induced in 14 patients during the control period and in 10 after propranolol (in 4 of whom the tachycardia could not be sustained because of atrioventricular [A-V] nodal refractoriness). Mean cycle length of tachycardia in these 10 patients was 328 ± 18 (control) and 352 ± 19 msec (propranolol) (P > 0.01). The increase in tachycardia cycle length reflected an increase in A-V nodal conduction time (A-H interval).In conclusion: (1) Propranolol has an insignificant effect on both anterograde and retrograde anomalous pathway properties. (2) In most cases, propranolol does not interfere with induction of sustained circus movement tachycardia. However, it does produce a statistically significant but slight slowing of the rate of tachycardia. (3) In a minority of cases, propranolol inhibits induction of sustained paroxysmal supraventricular tachycardia by increasing A-V nodal refractoriness.</abstract><qualityIndicators><score>7.005</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612 x 828 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1710</abstractCharCount><pdfWordCount>4137</pdfWordCount><pdfCharCount>29642</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>239</abstractWordCount></qualityIndicators><title>Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</title><pii><json:string>0002-9149(78)90858-5</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>41</volume><pii><json:string>S0002-9149(00)X0438-9</json:string></pii><pages><last>1067</last><first>1061</first></pages><issn><json:string>0002-9149</json:string></issn><issue>6</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>The American Journal of Cardiology</title><publicationDate>1978</publicationDate></host><publicationDate>1977</publicationDate><copyrightDate>1978</copyrightDate><doi><json:string>10.1016/0002-9149(78)90858-5</json:string></doi><id>5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1978</date></publicationStmt><notesStmt><note>This work was supported in part by Training Grant HL 05879-07 and Conduction Disease Grant PHS HL 18794-02 from the U.S. Public Health Service, Bethesda, Maryland.</note><note type="content">Section title: Clinical study</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</title><author><persName><forename type="first">Pablo</forename><surname>Denes</surname></persName><roleName type="degree">MD, FACC</roleName><note type="biography">Address for reprints: Pablo Denes, MD, Cardiology Section, University of Illinois Hospital, P.O. Box 6998, Chicago, Illinois 60680.</note><affiliation>Address for reprints: Pablo Denes, MD, Cardiology Section, University of Illinois Hospital, P.O. Box 6998, Chicago, Illinois 60680.</affiliation><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author><author><persName><forename type="first">James M.</forename><surname>Cummings</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author><author><persName><forename type="first">Ross</forename><surname>Simpson</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author><author><persName><forename type="first">Delon</forename><surname>Wu</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author><author><persName><forename type="first">Fernando</forename><surname>Amat-Y-leon</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author><author><persName><forename type="first">Ramesh</forename><surname>Dhingra</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author><author><persName><forename type="first">Kenneth M.</forename><surname>Rosen</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(00)X0438-9</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977"></date><biblScope unit="volume">41</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1061">1061</biblScope><biblScope unit="page" to="1067">1067</biblScope></imprint></monogr><idno type="istex">5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB</idno><idno type="DOI">10.1016/0002-9149(78)90858-5</idno><idno type="PII">0002-9149(78)90858-5</idno><idno type="ArticleID">78908585</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1978</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Electrophysiologic effects of intravenous propranolol, 0.1 mg/kg, were evaluated in 18 patients with anomalous pathways utilizing intracardiac stimulation and recording. Fourteen patients had Wolff-Parkinson-White syndrome and four had concealed ventricular preexcitation. Anomalous pathway effective refractory period could be measured during the control period and after propranolol administration in nine patients and was 304 ± 7.5 (mean ± standard error of the mean) and 304 ± 8.3 msec, respectively (difference not significant). Ventricular paced 1:1 ventriculoatrial (V-A) conduction (reflecting retrograde anomalous pathway conduction) measured in 12 patients was intact during both the control period and after propranolol at rates of 170 to 200/min. Sustained paroxysmal supraventricular tachycardia was induced in 14 patients during the control period and in 10 after propranolol (in 4 of whom the tachycardia could not be sustained because of atrioventricular [A-V] nodal refractoriness). Mean cycle length of tachycardia in these 10 patients was 328 ± 18 (control) and 352 ± 19 msec (propranolol) (P < 0.01). The increase in tachycardia cycle length reflected an increase in A-V nodal conduction time (A-H interval).In conclusion: (1) Propranolol has an insignificant effect on both anterograde and retrograde anomalous pathway properties. (2) In most cases, propranolol does not interfere with induction of sustained circus movement tachycardia. However, it does produce a statistically significant but slight slowing of the rate of tachycardia. (3) In a minority of cases, propranolol inhibits induction of sustained paroxysmal supraventricular tachycardia by increasing A-V nodal refractoriness.</p></abstract></profileDesc><revisionDesc><change when="1977-11-16">Registration</change><change when="1977-11-14">Modified</change><change when="1977">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJC</jid><aid>78908585</aid><ce:pii>0002-9149(78)90858-5</ce:pii><ce:doi>10.1016/0002-9149(78)90858-5</ce:doi><ce:copyright type="unknown" year="1978"></ce:copyright></item-info><head><ce:article-footnote><ce:label>☆</ce:label><ce:note-para>This work was supported in part by Training Grant HL 05879-07 and Conduction Disease Grant PHS HL 18794-02 from the U.S. Public Health Service, Bethesda, Maryland.</ce:note-para></ce:article-footnote><ce:dochead><ce:textfn>Clinical study</ce:textfn></ce:dochead><ce:title>Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</ce:title><ce:author-group><ce:author><ce:given-name>Pablo</ce:given-name><ce:surname>Denes</ce:surname><ce:degrees>MD, FACC</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>James M.</ce:given-name><ce:surname>Cummings</ce:surname><ce:degrees>MD, FACC</ce:degrees></ce:author><ce:author><ce:given-name>Ross</ce:given-name><ce:surname>Simpson</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Delon</ce:given-name><ce:surname>Wu</ce:surname><ce:degrees>MD, FACC</ce:degrees></ce:author><ce:author><ce:given-name>Fernando</ce:given-name><ce:surname>Amat-Y-leon</ce:surname><ce:degrees>MD, FACC</ce:degrees></ce:author><ce:author><ce:given-name>Ramesh</ce:given-name><ce:surname>Dhingra</ce:surname><ce:degrees>MD, FACC</ce:degrees></ce:author><ce:author><ce:given-name>Kenneth M.</ce:given-name><ce:surname>Rosen</ce:surname><ce:degrees>MD, FACC</ce:degrees></ce:author><ce:affiliation><ce:textfn>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Pablo Denes, MD, Cardiology Section, University of Illinois Hospital, P.O. Box 6998, Chicago, Illinois 60680.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="6" month="9" year="1977"></ce:date-received><ce:date-revised day="14" month="11" year="1977"></ce:date-revised><ce:date-accepted day="16" month="11" year="1977"></ce:date-accepted><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Electrophysiologic effects of intravenous propranolol, 0.1 mg/kg, were evaluated in 18 patients with anomalous pathways utilizing intracardiac stimulation and recording. Fourteen patients had Wolff-Parkinson-White syndrome and four had concealed ventricular preexcitation. Anomalous pathway effective refractory period could be measured during the control period and after propranolol administration in nine patients and was 304 ± 7.5 (mean ± standard error of the mean) and 304 ± 8.3 msec, respectively (difference not significant). Ventricular paced 1:1 ventriculoatrial (V-A) conduction (reflecting retrograde anomalous pathway conduction) measured in 12 patients was intact during both the control period and after propranolol at rates of 170 to 200/min. Sustained paroxysmal supraventricular tachycardia was induced in 14 patients during the control period and in 10 after propranolol (in 4 of whom the tachycardia could not be sustained because of atrioventricular [A-V] nodal refractoriness). Mean cycle length of tachycardia in these 10 patients was 328 ± 18 (control) and 352 ± 19 msec (propranolol) (<ce:italic>P</ce:italic> < 0.01). The increase in tachycardia cycle length reflected an increase in A-V nodal conduction time (A-H interval).</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">In conclusion: (1) Propranolol has an insignificant effect on both anterograde and retrograde anomalous pathway properties. (2) In most cases, propranolol does not interfere with induction of sustained circus movement tachycardia. However, it does produce a statistically significant but slight slowing of the rate of tachycardia. (3) In a minority of cases, propranolol inhibits induction of sustained paroxysmal supraventricular tachycardia by increasing A-V nodal refractoriness.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation</title></titleInfo><name type="personal"><namePart type="given">Pablo</namePart><namePart type="family">Denes</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><description>Address for reprints: Pablo Denes, MD, Cardiology Section, University of Illinois Hospital, P.O. Box 6998, Chicago, Illinois 60680.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">James M.</namePart><namePart type="family">Cummings</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ross</namePart><namePart type="family">Simpson</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Delon</namePart><namePart type="family">Wu</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fernando</namePart><namePart type="family">Amat-Y-leon</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ramesh</namePart><namePart type="family">Dhingra</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kenneth M.</namePart><namePart type="family">Rosen</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine and West Side Veterans' Administration Hospital, Division of Adult Cardiology, Chicago, Illinois USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1977</dateIssued><dateValid encoding="w3cdtf">1977-11-16</dateValid><dateModified encoding="w3cdtf">1977-11-14</dateModified><copyrightDate encoding="w3cdtf">1978</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Electrophysiologic effects of intravenous propranolol, 0.1 mg/kg, were evaluated in 18 patients with anomalous pathways utilizing intracardiac stimulation and recording. Fourteen patients had Wolff-Parkinson-White syndrome and four had concealed ventricular preexcitation. Anomalous pathway effective refractory period could be measured during the control period and after propranolol administration in nine patients and was 304 ± 7.5 (mean ± standard error of the mean) and 304 ± 8.3 msec, respectively (difference not significant). Ventricular paced 1:1 ventriculoatrial (V-A) conduction (reflecting retrograde anomalous pathway conduction) measured in 12 patients was intact during both the control period and after propranolol at rates of 170 to 200/min. Sustained paroxysmal supraventricular tachycardia was induced in 14 patients during the control period and in 10 after propranolol (in 4 of whom the tachycardia could not be sustained because of atrioventricular [A-V] nodal refractoriness). Mean cycle length of tachycardia in these 10 patients was 328 ± 18 (control) and 352 ± 19 msec (propranolol) (P < 0.01). The increase in tachycardia cycle length reflected an increase in A-V nodal conduction time (A-H interval).In conclusion: (1) Propranolol has an insignificant effect on both anterograde and retrograde anomalous pathway properties. (2) In most cases, propranolol does not interfere with induction of sustained circus movement tachycardia. However, it does produce a statistically significant but slight slowing of the rate of tachycardia. (3) In a minority of cases, propranolol inhibits induction of sustained paroxysmal supraventricular tachycardia by increasing A-V nodal refractoriness.</abstract><note>This work was supported in part by Training Grant HL 05879-07 and Conduction Disease Grant PHS HL 18794-02 from the U.S. Public Health Service, Bethesda, Maryland.</note><note type="content">Section title: Clinical study</note><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19780522</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0438-9</identifier><part><date>19780522</date><detail type="issue"><title>Symposium on New Aspects of Antiarrhythmic Therapy</title></detail><detail type="volume"><number>41</number><caption>vol.</caption></detail><detail type="issue"><number>6</number><caption>no.</caption></detail><extent unit="issue pages"><start>A20</start><end>A28</end></extent><extent unit="issue pages"><start>A3</start><end>A17</end></extent><extent unit="issue pages"><start>A30</start><end>A42</end></extent><extent unit="issue pages"><start>975</start><end>1126</end></extent><extent unit="pages"><start>1061</start><end>1067</end></extent></part></relatedItem><identifier type="istex">5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB</identifier><identifier type="DOI">10.1016/0002-9149(78)90858-5</identifier><identifier type="PII">0002-9149(78)90858-5</identifier><identifier type="ArticleID">78908585</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/5839A092A7D8A71CBCDC2C1F9EC5B97C8BEBADBB/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><analytic><title level="a" 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