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Daily variability of electrically induced reciprocating tachycardia in patients with atrioventricular accessory pathways

, : Daily variability of electrically induced reciprocating tachycardia in patients with atrioventricular accessory pathways. American Heart Journal 114(2): 327-333

Sequential bedside electrophysiologic testing was performed over 22 hours at intervals of 1 to 2 hours in 13 patints with left-sided Kent bundles to assess possible daily variations in the capacity to electrically induce reciprocating tachycardia. In all patients with tachycardia involved the accessory pathway in retrograde atrial activation. Between midnight and early morning the more relevant findings with respect to the first testing performed at midday were a significant prolongation of the effective refractory period of the atrial (from 212 .+-. 22 msec to 229 .+-. 22 msec; p < 0.01), atrioventricular node (from 235 .+-. 22 msec to 285 .+-. 15 msec; p < 0.005), right ventricle (from 209 .+-. 15 msec to 221 .+-. 12 msec; p < 0.001), and retrograde Kent bundle (from 278 .+-. 34 msec to 294 .+-. 24 msec; p < 0.01) and a reduction of the inducibility of tachycardia from both the coronary sinus from 90% to 50%; p < 0.001) and the right ventricle from 80% to 15%; p < 0.0001). THus our results indicate that there exists a nocturnal protection against electrical induction of reciprocating tachycardia that is associated with a prolongation of the atrial atrioventricular nodal, ventricular, and Kent bundle refractoriness.


PMID: 3604890

DOI: 10.1016/0002-8703(87)90499-6

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