Document Detail


Reflex mechanisms responsible for early spontaneous termination of paroxysmal supraventricular tachycardia.
MedLine Citation:
PMID:  6120648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence and possible mechanism of early spontaneous termination of paroxysmal supraventricular tachycardia was studied in 20 consecutive patients. Episodes of induced tachycardia that terminated spontaneously within the 1st minute after initiation were included. Tachycardias ending spontaneously were associated with a reproducible course of hypotension at the onset followed by blood pressure recovery above control levels and termination. Spontaneous termination of tachycardias occurred within the A-V node 18 to 45 seconds (mean +/- standard error of the mean 27.9 +/- 5.3) after their onset. In the supine position (0 degrees) 9 (45 percent) of 20 patients showed spontaneous termination in 36 (16 percent) of 219 episodes of tachycardia. In the head-dependent position (-20 degrees) only 1 (8 percent) of 13 patients manifested spontaneous termination in 2 (4 percent) of 54 episodes. In the head up position (+60 degrees) only 1 (6 percent) of 18 patients exhibited termination in 2 (2 percent) of 102 episodes. After partial cholinergic blockade with intravenous hyoscine butylbromide, 20 mg, or atropine, 0.6 mg, none of five patients showed spontaneous termination in 25 episodes. After beta adrenergic blockade with 10 mg of propranolol intravenously, none of 16 patients showed spontaneous termination in 87 episodes of tachycardia. We conclude that the initial hypotension during tachycardia evokes a sympathetic response that increases blood pressure and this increase in turn causes a rise in vagal tone that breaks the tachycardia.
Authors:
M B Waxman; A D Sharma; D A Cameron; F Huerta; R W Wald
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  49     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1982 Feb 
Date Detail:
Created Date:  1982-04-12     Completed Date:  1982-04-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  259-72     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Adult
Aged
Atropine / therapeutic use
Blood Pressure
Electric Stimulation / adverse effects
Electrocardiography
Female
Heart Ventricles / physiopathology*
Humans
Hypotension / etiology,  physiopathology
Male
Middle Aged
Parasympatholytics / therapeutic use
Posture
Propranolol / therapeutic use
Reflex / physiology*
Scopolamine / therapeutic use
Tachycardia, Paroxysmal / drug therapy,  etiology,  physiopathology*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Parasympatholytics; 51-34-3/Scopolamine; 51-55-8/Atropine; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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