Role of the autonomic nervous system in the genesis of first and second degree atrio-ventricular nodal block

P. Alboni, R. Pirani, N. Paparella, R. Cappato, S. Preziosi, A. M. Tomasi

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Abstract

Thirty-four patients with a prolonged A-H interval (group I) and 26 with A-V nodal Wenckebach block (group II) were studied in the basal state and after autonomic blockade (propranolol 0.2 mg kg-1 and atropine 0.04 mg kg-1 in order to assess the role of autonomic system in A-V nodal conduction disturbances. In group I, the A-H intervals did not change significantly after autonomic blockade, whereas pacing cycle length for Wenckebach block, effective and functional refractory periods of the A-V node decreased significantly (P <0.05). In the 22 patients with organic heart disease these variables did not change significantly after autonomic blockade, whereas in the 12 without underlying heart disease, they decreased in all cases (P <0.001). In the former, the variables of intrinsic A-V nodal conduction were normal in only 9% of patients, whereas in the latter they were normal in 66%. Also in group II, the intrinsic A-H intervals were normal in only 6% of patients with cardiac disease but were normal in 63% without underlying heart disease. These data suggest that in the patients with first and second degree A-V nodal block and organic heart disease, the conduction disturbance is predominantly related to intrinsic involvement of A-V node, whereas in the subjects without underlying heart disease the A-V nodal blocks appear mainly related to autonomic alterations.

Original languageEnglish
Pages (from-to)952-960
Number of pages9
JournalEuropean Heart Journal
Volume7
Issue number11
Publication statusPublished - 1986

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Physiology

Cite this

Alboni, P., Pirani, R., Paparella, N., Cappato, R., Preziosi, S., & Tomasi, A. M. (1986). Role of the autonomic nervous system in the genesis of first and second degree atrio-ventricular nodal block. European Heart Journal, 7(11), 952-960.