Parasympathetic effects on cardiac electrophysiology during exercise and recovery

Prince J. Kannankeril, Jeffrey Goldberger

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Depressed parasympathetic tone is associated with an increased risk of sudden cardiac death. Exercise and the postexercise recovery period, which are associated with parasympathetic withdrawal, are high risk periods for sudden death. However, parasympathetic effects on cardiac electrophysiology during exercise and recovery have not been described. Electrophysiology studies were performed using noninvasive programmed stimulation (NIPS) in nine subjects (age 59 ± 18 yr) with implanted dual-chamber devices and normal left ventricular function during multiple bicycle exercise sessions. NIPS was performed at rest, during exercise, and in the early recovery period both before and after parasympathetic blockade with atropine. Parasympathetic effect was defined as the value of the parameter of interest in the absence of atropine minus the value of the parameter in the presence of atropine. During exercise, sinus cycle length, atrioventricular (AV) block cycle length, AV interval, and ventricular effective refractory period shortened; in recovery, the values were intermediate between the rest and exercise values (P < 0.0001 by ANOVA). Parasympathetic effects on sinus cycle length, AV block cycle length, AV interval, and ventricular effective refractory period were 247 ± 140, 58 ± 20, 76 ± 20, and 8.6 ± 7.5 ms at rest, 106 ± 20, 37 ± 14, 24 ± 13, and 2.6 ± 7.8 ms during exercise, and 209 ± 114, 50 ± 23, 35 ± 21, and 9.5 ± 11.8 ms during recovery, respectively. There was poor correlation among the parasympathetic effects noted at the sinus node, AV node, and ventricle. Further work evaluating parasympathetic effects on cardiac electrophysiology during exercise and recovery in patients with heart disease is required to elucidate its role in modulating the risk of sudden cardiac death noted at these times.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume282
Issue number6 51-6
StatePublished - Jul 2 2002
Externally publishedYes

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Cardiac Electrophysiology
Exercise
Atropine
Atrioventricular Block
Sudden Cardiac Death
Atrioventricular Node
Sinoatrial Node
Electrophysiology
Sudden Death
Left Ventricular Function
Heart Diseases
Analysis of Variance
Equipment and Supplies

Keywords

  • Exercise

ASJC Scopus subject areas

  • Physiology

Cite this

Parasympathetic effects on cardiac electrophysiology during exercise and recovery. / Kannankeril, Prince J.; Goldberger, Jeffrey.

In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 282, No. 6 51-6, 02.07.2002.

Research output: Contribution to journalArticle

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