Circulation, Vol 82, 60-68, Copyright © 1990 by American Heart Association
LS Klein, WM Miles and DP Zipes
To determine whether a contraction-excitation feedback mechanism exists in
human atrium, we investigated the effects of varying the atrioventricular
(AV) interval from 0 to 360 msec during AV pacing at a cycle length of 400
msec on atrial pressure, size, and refractoriness in 10 patients (group 1,
without supraventricular tachycardia). The same parameters were determined
in another 10 patients (group 2, with different spontaneous AV relations)
during AV reciprocating tachycardia or AV nodal reciprocating tachycardia
and during high right atrial (RA) pacing at the tachycardia cycle length.
In group 1 patients, peak and mean RA pressure, RA effective refractory
period (RA-ERP), and left atrial (LA) size all decreased to minimal values
at an AV interval of 120 msec and remained low as the AV interval was
increased and approached 400 msec. The increase in each of the variables
from its lowest to greatest value was as follows: Mean systemic blood
pressure, 20.9 +/- 3.1 mm Hg; LA size, 0.55 +/- 0.05 cm; RA peak pressure,
10.4 +/- 1.8 mm Hg; RA mean pressure, 3.5 +/- 0.6 mm Hg; and RA-ERP, 22.5
+/- 3.0 msec, p less than 0.001 for each. The weighted mean correlation
coefficient with RA-ERP was significant for RA peak pressure and LA size (p
less than 0.001 for each). These same relations were investigated in five
patients with the Wolff-Parkinson-White syndrome and AV reciprocating
tachycardia and five patients with AV nodal reciprocating tachycardia
(group 2).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Effect of atrioventricular interval during pacing or reciprocating tachycardia on atrial size, pressure, and refractory period. Contraction-excitation feedback in human atrium
Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis 46202.
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