Effetti del tono vagale sulla conduzione nel fascio di Kent in soggetti con sindrome di Wolff-Parkinson-White.

Translated title of the contribution: Effects of vagal tone on Kent bundle conduction in patients with Wolff-Parkinson-White syndrome

N. Paparella, R. Cappato, P. Alboni

Research output: Contribution to journalArticle

Abstract

BACKGROUND. The influences of the sympathetic tone on the conduction in the Kent bundle have been widely investigated; on the contrary, very little is known about the effects of the vagal tone on such a bypass. Vagal influences on Kent bundle can be adequately investigated only after sympathetic blockade. METHODS. An electrophysiological study was performed in 12 subjects with Wolff-Parkinson-White syndrome (7 F and 5 M, age: 30 +/- 17 years) during basal state, after beta-blockade (propranolol 0.2 mg/Kg iv) and after atropine (0.04 mg/Kg iv). RESULTS. In no subject were signs of organic heart disease present. The anterograde effective refractory period of the bypass significantly lengthened after propranolol (291 +/- 65 ms vs 313 +/- 52 ms, p <.01), and shortened after atropine (313 +/- 52 ms vs 290 +/- 46 ms, p <.01). This parameter showed no significant differences in the basal state nor after complete autonomic blockade. The longest pacing atrial cycle length for a second degree atrio-ventricular block in the bypass significantly lengthened after propranolol (322 +/- 55 ms vs 383 +/- 44 ms, p <.01) and shortened after atropine, even if the variation was not statistically significant (383 +/- 44 ms vs 368 +/- 39 ms, p: NS); such a parameter was significantly more prolonged after complete autonomic blockade than in the basal state (p <.05). The retrograde conduction in the bypass showed a similar behaviour: the retrograde effective refractory period and the longest ventricular pacing cycle length for a second degree ventriculo-atrial block significantly lengthened after propranolol (434 +/- 133 ms vs 532 +/- 188 ms, p <.01 and 398 +/- 150 ms vs 492 +/- 179 ms, p <.01, respectively) and shortened after atropine (532 +/- 188 ms vs 464 +/- 157 ms, p <.01, and 492 +/- 179 ms vs 431 +/- 158 ms, p <.05, respectively). These parameters were more prolonged after complete autonomic blockade than in the basal state (p <.05). CONCLUSIONS. These data evidence a vagal influence on the conduction in the resting Kent bundle; the vagal effect appears, however, less marked than the sympathetic one.

Translated title of the contributionEffects of vagal tone on Kent bundle conduction in patients with Wolff-Parkinson-White syndrome
Original languageItalian
Pages (from-to)29-37
Number of pages9
JournalGiornale Italiano di Cardiologia
Volume23
Issue number1
Publication statusPublished - Jan 1993

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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