Effects of beta-adrenergic stimulation on atrial latency and atrial vulnerability in patients with paroxysmal supraventricular tachycardia

Am J Cardiol. 1988 May 1;61(13):1031-6. doi: 10.1016/0002-9149(88)90120-8.

Abstract

To assess the effects of beta-adrenergic stimulation on atrial latency and atrial vulnerability, the electrophysiologic properties of the atrium were studied before and during intravenous infusion of isoproterenol at 2 to 5 micrograms/min in 11 patients with paroxysmal supraventricular tachycardia exhibiting atrial latency during programmed atrial extrastimulation. In all patients, the isoproterenol infusion reduced the extent of maximum atrial latency (from 86 +/- 19 to 62 +/- 16 ms, p less than 0.001). This was accompanied by a significant shortening of both effective and functional refractory periods of the atrium (from 213 +/- 31 to 174 +/- 40 ms, p less than 0.005 and from 259 +/- 31 to 215 +/- 29 ms, p less than 0.001, respectively). The intra-atrial and interatrial conduction times were also significantly reduced (from 24 +/- 15 and 63 +/- 17 to 15 +/- 10 and 48 +/- 15 ms, p less than 0.005, respectively). In 3 patients with demonstrable atrial vulnerability, the isoproterenol infusion abolished the inducibility of repetitive atrial responses or atrial flutter, or both. Although the clinical significance of the suppressive action of beta-adrenergic stimulation on atrial vulnerability remains to be determined, the present study has demonstrated that beta-adrenergic stimulation significantly reduces atrial latency.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Cardiac Pacing, Artificial
  • Drug Evaluation
  • Female
  • Heart Atria / drug effects
  • Heart Atria / physiopathology*
  • Heart Conduction System / drug effects*
  • Humans
  • Infusions, Intravenous
  • Isoproterenol / administration & dosage
  • Isoproterenol / pharmacology*
  • Male
  • Middle Aged
  • Propranolol / administration & dosage
  • Propranolol / pharmacology
  • Reaction Time / drug effects*
  • Recurrence
  • Tachycardia, Paroxysmal / physiopathology*
  • Tachycardia, Supraventricular / physiopathology*

Substances

  • Propranolol
  • Isoproterenol