PubMed HealthSearch

PubMed · 1210510

[Sinus node automaticity and sinoatrial conduction].

Abstract

In 64 patients so-called sino-atrial conduction time (SACT) was calculated by means of the extrastimulus technique. The normal value of this parameter was 82 plus or minus 18.7 ms (20 patients). Plotting SACT versus heart rate in all patients no correlation could be found. However, in 4 patients with spontaneous variations of the sinus cycle length a short SACT was calculated after long spontaneous intervals and vice verse. These results may indicate that SACT ist frequency-dependent. However, it is not clear whether the behaviour of the postextra-systolic pauses in these patients is due to changes of SACT or due to spontaneous variations of sinus node automaticity. The measurement of the first spontaneous interval (A3-A4) after the postextrasystolic pause revealed a prolongation of 30 ms (mean value) in comparison to the basic cycle length (A1-A1) after resetting the sinus node. If the stimulus was elicited late in diastole without premature depolarisation of the pacemaker cells, no significant difference between A3-A4 and A1-A1 intervals could be found. These results indicate that sinus node automaticity may be influenced by the premature stimulus. Therefore, the calculation of SACT is burdened by unresolved methodological problems.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

L Seipel, G Breithardt. 1975. [Sinus node automaticity and sinoatrial conduction].. https://pubmed.ncbi.nlm.nih.gov/1210510/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Analysis of vagally induced sinus arrhythmias.

Vagal stimulation at precise times in successive cardiac cycles can elicit sinus arrhythmias. Two mechanisms have been identified that can, but do not necessarily, cause these vagally induced sinus arrhythmias. First, changes in cycle length elicited by a given concentration of acetylcholine (ACh) depend on the phase of the pacemaker cell action potential when the ACh binds to muscarinic receptors. Second, acetylcholinesterase degrades ACh rapidly enough for the mean concentration of ACh per cardiac cycle to vary from cycle to cycle. We used a mathematical model of the underlying cellular physiology, to examine whether these mechanisms are responsible for arrhythmogenesis. Computer simulation showed that both mechanisms contribute to the vagally induced sinus arrhythmias.

Arrhythmias, Cardiac

Prognosis of patients with sustained ventricular tachycardia and of survivors of cardiac arrest not inducible by programmed stimulation.

The aim of this study was to analyze the long-term clinical outcome of 60 prospectively studied patients with documented sustained ventricular tachyarrhythmia that was not inducible during baseline programmed ventricular stimulation: 39 with cardiac arrest due to noninfarction ventricular fibrillation (VF) and 21 with mild hemodynamically compromising sustained ventricular tachycardia (VT). Left ventricular ejection fraction was 55 +/- 14% in the VF group and 50 +/- 13% in the VT group (difference not significant). Patients were discharged without conventional antiarrhythmic drugs and received only empirical beta-blocker therapy. During a mean follow-up period of 21 +/- 16 months (mean +/- SD), 10 of 60 patients (17%) died suddenly. The actuarial incidence of sudden death at 1 and 4 years was similar in both groups (VF group, 10 and 20%; VT group, 16 and 16%) (p = 0.48). The actuarial incidence of sudden cardiac death was significantly higher in patients with left ventricular ejection fraction < or = 40% than in those with > 40% (1-year incidence in VF group, 40 vs 0%; VT group, 50 vs 0%) (p = 0.005 and p = 0.01, respectively). Multivariate regression analysis identified left ventricular ejection fraction < or = 40% and previous myocardial infarction as the only independent predictor of sudden cardiac death. The occurrence of frequent ventricular pairs during Holter monitoring was the only independent predictor of sustained VT recurrences. It is concluded that patients with sustained ventricular tachyarrhythmia in whom arrhythmia was non-inducible during baseline ventricular stimulation and not treated with antiarrhythmic therapy have a favorable outcome if left ventricular ejection fraction is high.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac