Sympathetic and vagal influences on rate-dependent changes of QT interval in healthy subjects

Riccardo Cappato, Paolo Alboni, Paolo Pedroni, Giuseppe Gilli, GianEnrico Antonioli

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Dependence of QT interval duration on cardiac heart rate has been well established and is considered to be an intrinsic property of ventricular myocardium. Conclusive results of autonomic influences on such phenomena are lacking. To evaluate whether rate-dependent changes of QT interval are conditioned by the autonomic nervous system, 28 normal subjects with no heart disease and a normal QT interval were electrophysiologically assessed. The QT interval was calculated at 6 paced cycle lengths (600, 540, 500, 460, 430 and 400 ms) during the basal state, and after β blockade (propranolol 0.2 mg/kg) and autonomic blockade (propranolol plus atropine 0.04 mg/kg). Because of atrioventricular nodal conduction limits, intrapatient cross-comparisons were performed in 10 subjects (aged 42 ± 15 years). Single regression lines, evaluated in each subject, showing correlation between pacing cycle length and QT duration at each of the 3 states were analyzed. The mean slope observed after autonomic blockade (b = 0.10 ± 0.04) was significantly lower than that seen during the basal state (b = 0.22 ± 0.12, p <0.05) and after β blockade (b = 0.23 ± 0.08, p <0.05); nonsignificant differences were found between slopes during the basal state and after β blockade. Results showed that vagal tone increased intrinsic dependence of QT at increasing cycle length, whereas sympathetic tone did not seem to interfere significantly. Since (in each subject) β blockade was performed-or achieved-before atropine administration, the vagal influences are likely to be directly exerted on the ventricular electrophysiologic substrate.

Original languageEnglish
Pages (from-to)1188-1193
Number of pages6
JournalThe American Journal of Cardiology
Issue number11
Publication statusPublished - Nov 1 1991

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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