Effect of ventricular extrasystoles on idioventricular rhythm in patients with complete heart block

1978 ◽  
Vol 12 (12) ◽  
pp. 703-711
Author(s):  
B. M. KENNELLY ◽  
G. K. LANE
1959 ◽  
Vol 14 (6) ◽  
pp. 956-960 ◽  
Author(s):  
Philip Samet ◽  
Robert S. Litwak ◽  
William H. Bernstein ◽  
Norman Kenyon

Right and left ventricular pressure curves were recorded simultaneously with the electrocardiogram in the dog. Control observations were made during sinus tachycardia with normal intraventricular conduction, and repeated after production of right and left bundle-branch block and after production of complete heart block with idioventricular rhythm. The mode relationship between onset of isometric contraction in the two ventricles was 0.00 seconds during sinus tachycardia. During right bundle-branch block, left ventricular contraction started 0.01 second prior to the right; during left bundle-branch block, right ventricular contraction started 0.02 second prior to the left. During left ventricular idioventricular rhythm, left ventricular isometric contraction started 0.01 second prior to the right; during right ventricular idioventricular rhythm, right ventricular contraction started 0.01 second prior to the left. These changes in relative onset of ventricular contraction are far less than those expected on theoretical grounds. Submitted on March 26, 1959


1982 ◽  
Vol 242 (4) ◽  
pp. H677-H682
Author(s):  
A. J. Hordof ◽  
E. Rose ◽  
P. Danilo ◽  
M. R. Rosen

We studied the effects of epinephrine on idioventricular rhythm in 15 adult dogs with chronic complete heart block induced by the injection of formalin into the His bundle. Atropine (0.1 mg/kg) was given intravenously to attenuate any potential vagal effects, and epinephrine was infused in graded doses of 0.01-10.0 micrograms.kg-1.min-1. Two different responses were seen. In 12 dogs there was a concentration-dependent increase in ventricular rate following epinephrine infusion. These animals then were given the beta-blocker propranolol (0.5 mg/kg iv), and the epinephrine infusions were repeated. In this situation epinephrine concentrations less than 0.1 micrograms.kg-1.min-1 induced a decrease in ventricular rate with no associated change in arterial pressure. In four additional dogs this decrease in ventricular rate was prevented by alpha-blockade with phentolamine. In three dogs epinephrine less than 0.1 micrograms.kg-1.min-1 induced a decrease in ventricular rate without an associated change in arterial blood pressure. This decrease in rate was abolished by the alpha-blocker phentolamine. It therefore appears that an alpha-adrenergic effect on ventricular automaticity can occur in the intact animals. When this does not occur initially, it can be unmasked by propranolol and results in a slowing of ventricular rate unrelated to changes in blood pressure.


2007 ◽  
Vol 3 (2) ◽  
pp. 111
Author(s):  
Robert Campbell ◽  
Peter Fischbach ◽  
Patricio Frias ◽  
Margaret Strieper ◽  
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...  

2020 ◽  
Vol 02 ◽  
Author(s):  
Sharada Sivaram Kalavakolanu ◽  
Madan Mohan Balakrishnan ◽  
Deepesh Venkatarama

: We present a case of 75-year-old lady with effort intolerance and baseline ECG showing 2:1 atrio-ventricular block, in whom it was unclear as to requirement of permanent pacing, even after long term ECG monitoring. She underwent a tread mill test during which her QRS became wide and developed complete heart block within 2 minutes of the test. Thus, a simple exercise test helped in confirming level of block to be infra nodal without need for invasive study. In patients with exertional symptoms, even in elderly, and in those where ECG masquerades as a benign entity, exercise testing is useful to differentiate benign cases of atrio-ventricular block from the more serious cases that mandate a pacemaker implantation.


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