PMID: 6169039Sep 1, 1981Paper

Atropine-induced multilevel block in acute inferior myocardial infarction. A possible indication for prophylactic pacing

Pacing and Clinical Electrophysiology : PACE
A CastellanosR J Myerburg

Abstract

The degree of A-V block increased after intravenous administration of atropine in 10 nondigitalized patients with acute inferior myocardial infarction who had narrow QRS complexes during periods of 1:1 A-V conduction. Short episodes of 3:1, 4:1 and 5:1 A-V block were seen to emerge: (a) in 6 patients, directly from Wenckebach periods; (b) in 3 patients, from alternating Wenckebach periods; and (c) in 1 patient, from a 3:2 Wenckebach period which led to a short-lived alternating Wenckebach period. Apparently, the predominance of the chronotropic effects on the sinus node over the dromotropic effects on the A-V node led to a tachycardia-dependent (more ischemic than vagal) process, exposing or producing multi- (two, three or four) level block involving the A-V node (and perhaps the His bundle). Subsequently, therapeutic pacing was instituted in 9/10 patients because they developed spontaneous symptomatic advanced A-V block. Therefore, it is possible that the early effects of atropine identified a narrowly-defined subset of patients in whom prophylactic pacing may be indicated. However, more studies are necessary to corroborate these assumptions.

References

Dec 1, 1977·The American Journal of Cardiology·A CastellanosR J Myerburg
Dec 1, 1976·Circulation·B D KosowskyA M Radoff
Nov 1, 1975·The American Journal of Cardiology·F Amat y LeonK M Rosen
Jul 8, 1972·British Medical Journal·S W WebbJ F Pantridge
Mar 1, 1972·Circulation·M RotmanA G Wallace
Oct 22, 1970·The New England Journal of Medicine·B Lown, B D Kosowsky
Aug 17, 1972·The New England Journal of Medicine·R A MassumiR Zelis
May 1, 1969·British Heart Journal·R M Norris
Nov 1, 1970·Circulation·K M RosenR M Gunnar
May 1, 1971·The American Journal of Cardiology·C CastilloA Castellanos
Jul 1, 1980·American Heart Journal·P Schweitzer, H Mark
Oct 1, 1950·Circulation·M BESOAIN-SANTANDERR LANGENDORF

❮ Previous
Next ❯

Citations

May 14, 2005·Journal of Electrocardiology·Agustin CastellanosRobert J Myerburg
Dec 1, 1993·Pacing and Clinical Electrophysiology : PACE·A CastellanosR J Myerburg

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.