In 19 patients with healthy AV-nodes the adaptation of the intranodal conduction time (A-H time) to gliding increase and decrease in atrial frequency and to the blockade of the autonomic nervous system was investigated using His bundle electrograms. The measurements were performed during right atrial stimulation with three frequencies, each with a duration of one minute, before and after blockade of the parasympathetic (8 pat.; 1 mg atropine i.v.) and the sympathetic (11 pat.; 0.4 mg Visken i.v.) nervous system. Gliding increase and decrease in atrial frequency results in a staircase pattern of A-H-adaptation in 18 of the patients. The height of the steps was identical in both phases of stimulation in each individual patient. One patient showed functional dissociation of intranodal conduction which was different during increase and decrease of atrial frequency. With parasympathetic blockade the staircase behavior of the A-H time basically remained unchanged with the exception of shorter A-H intervals resulting in lower steps. Atropine abolished the functional dissociation of intranodal conduction; thus the drug might prevent reentrytachycardias due to functional dissociation in the AV-node. Sympathetic blockade lengthens the intranodal conduction time; thus shifting the staircase pattern of the A-H time to higher levels. The results are discussed with respect to the electrophysiological characteristics of AV nodal cells as slow response fibers, and to the changes caused by atrial stimulation, acetylcholine and adrenaline.

Atrioventricular Node↗

PubMedDate not supplied

[Influence of cycle length shortening, atropine and beta-receptor blockage on sinus node recovery time (SRT) in patients with healthy sinus node (author's transl)].

Sinus node recovery time (SRT) was measured in 30 patients with healthy sinus nodes to examine the influence of the increase in atrial frequency, atropine and beta-receptor blockade. The measurements were performed following pacing with 3 atrial frequencies before and after administration of 1 mg atropine i.v. (13 patients) and 0.4 mg prindolol (Visken) i.v. (17 patients). Total group; Increase of frequency alone caused prolongation of the SRT in 17 patients and shortening in 13 patients. Atropine group: Blockade of the parasympathicus alone induced a highly significant reduction in the SRT. Simultaneous increase in frequency and blockade of the parasympathicus led to greater SRT-shortening during low frequency than with high frequency. This interrelationship of frequency and blockade of the parasympathicus influencing the SRT is statistically significant. Visken-group: Blockade of the sympathicus causes a highly significant prolongation of the SRT. Simultaneous increase in frequency and blockade of the sympathicus led to greater SRT-prolongation during low frequency than with high frequency. This interrelationship of frequency and blockade of the sympathicus influencing the SRT has slight statistical significance. The results are discussed in respect to the electrophysiological influences of atrial cycle length shortening, acetylcholine and catecholamines on the sinus node, the perinodal atrial fibres and the atrial working myocardium.

Atropine↗