Endocardial stimulation of efferent parasympathetic nerves to the atrioventricular node in humans: optimal stimulation sites and the effects of digoxin

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
K J QuanM D Carlson

Abstract

The purposes of this study were to identify optimal sites of stimulation of efferent parasympathetic nerve fibers to the human atrioventricular node via an endocardial catheter and to investigate the interaction between digoxin and vagal activation at the end organ. The ventricular rate was measured during atrial fibrillation, prior to and during parasympathetic nerve stimulation, in 8 patients taking digoxin and in 10 controls. High frequency electrical stimuli were delivered via an hexapolar or quadripolar electrode catheter, placed at the posteroseptal right atrium near the atrioventricular node (n=18 patients) or in the coronary sinus (n=12 of 18 patients). In 4 patients, stimulation was repeated after intravenous administration of 1 to 2 mg of atropine. Nerve stimulation prolonged the R-R interval in all patients. Stimulation close to the posteroseptal right atrium led to maximal atrioventricular nodal slowing. The mean R-R intervals at baseline and during parasympathetic nerve stimulation (60 mA) from the posteroseptal right atrium and the proximal coronary sinus were 581+/-79 ms, 2440+/-466, and 900+/-228 ms respectively (p=0.0001). The response to nerve stimulation was greater in patients taking digoxin than in patients...Continue Reading

Citations

Feb 28, 2008·Journal of Cardiovascular Medicine·Alessandro CapucciTiziana Marotta
Mar 11, 2004·Pacing and Clinical Electrophysiology : PACE·Youhua Zhang, Todor N Mazgalev
Aug 31, 2019·Molecular and Cellular Biochemistry·Reetish SinglaDinender K Singla
Oct 13, 2006·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Alberto DiazKara J Quan
Sep 2, 2008·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Pietro RossiFabio Miraldi
Nov 17, 2009·Journal of Cardiovascular Electrophysiology·Jacques Billette, Rafik Tadros
Oct 5, 2011·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Lilian KornetRichard Cornelussen

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