Electrocardiographic criteria for vagotonia-validation with pharmacological parasympathetic blockade in healthy subjects.
نویسندگان
چکیده
BACKGROUND The importance of vagal tone on cardiac function and cardiovascular mortality is well established. Although the presence of an enhanced cardiac vagal tone (CVT) is frequently diagnosed using the 12-lead resting electrocardiogram (ECG) in daily practice, most of the proposed criteria have been determined on an empirical basis. Our objective was to evaluate the effects of pharmacological blockade of the parasympathetic component of the autonomic nervous system on resting ECG tracings. METHODS Nine healthy young adults (24+/-5 year-old) underwent parasympathetic blockade with atropine sulfate i.v. (0.04 mg kg(-1)) and resting ECGs were obtained before and 15 min thereafter. CVT was assessed by a dimensionless index, which measures the RR interval reduction caused by the vagal withdrawal induced by a 4-s exercise test performed on a cycle ergometer where the subjects pedal as fast as possible with no added resistance. RESULTS This index was 1.63+/-0.24 and 1.03+/-0.03, before and after atropine, respectively (P<0.0001). Atropine reduced the R-R intervals (P<0.0001), and the amplitude of T-waves in several leads (DII: P=0.03; V4: P=0.04; V5: P=0.03; V6: P=0.01), and abolished the appiculation of T-waves, J-point and ST-segment elevations (P<0.05), and U-waves (P<0.05), which were present in baseline ECG in all subjects in at least two leads. The R-wave amplitude in leads V4, V5, and V6 (all P>/=0.10) was not modified by atropine infusion. CONCLUSION The duration of the R-R intervals and the amplitude of T-waves in leads DII, V4, V5, and V6, and the presence of T-wave appiculation, U-waves, and elevation of J-point and ST-segment should be used to detect enhanced cardiac vagal tone in healthy subjects.
منابع مشابه
Reversal of Electrocardiographic Sodium Channel Blockade Changes with Bicarbonate Therapy in a Pediatric Patient Post-Cardiopulmonary Arrest Secondary to Methadone Toxicity
متن کامل
Clinical and Electrocardiographic comparison of patients with primary Mitral Valve Prolapse Syndrome and control group
ABSTRACT: Mitral Valve Prolapse (WVP) in one of the commonest cardiac abnormalities. Echocardiography has generally been accepted as the diagnostic modality of choice, To assess the characteristic symptoms signs and electrocardiographic abnormalities of MVP results of prospective 500 age and sex matched healthy subjects without echocardiographic MVP (control subjects). The diagnostic criteria...
متن کاملCardiac sympathetic blockade during spinal anesthesia involves both efferent and afferent pathways.
To the Editor-We would like to thank Drs. Thnish and Downs for their interesting case report, “Vagotonia and Cardiac Arrest during Spinal Anesthesia.”’ These authors discuss the contribution of sympathetic and parasympathetic nervous system imbalance during spinal anesthesia as a mechanism of asystole. They state that in a patient with vasovagal syncope, the combination of cardiac sympathetic b...
متن کاملEthical issues on informed consent and recruitment for clinical trials.
In Rep.ply:-I would like to thank Ilrs. Introna and Blair for making several interesting comments regarding the reported case of vagotonia and cardiac arrest during a spind anesthetic. I agree that in most individuals the sympathetic and parasympathetic systems remains remarkably balanced, despite significant blockade of the sympathetic afferent and efferent pathways during spinal anesthesia. O...
متن کاملSympathetic and parasympathetic innervation of pupillary dilation during sustained processing.
The contributions of separate sympathetic and parasympathetic pathways to pupillary dilation during a sustained processing task were studied through environmental and pharmacological manipulations. In Experiment 1, 22 healthy volunteers (11 female) performed a serial Subtract 7 task while pupil diameter was recorded both during moderate room light and in darkness. In a control for verbalization...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- International journal of cardiology
دوره 87 2-3 شماره
صفحات -
تاریخ انتشار 2003