Why the study?
Does intravenous nitroprusside alter electrophysiologic properties and refractory periods in patients with heart disease?
Does intravenous nitroprusside alter electrophysiologic properties and refractory periods in patients with heart disease?
Intravenous nitroprusside improves AV nodal and ventriculoatrial conduction, likely secondary to reflex sympathetic activation from systemic hypotension.
The effects of nitroprusside on His bundle electrograms, when given intravenously for 10 minutes, were studied in 14 patients with heart disease. Recordings were made at varied heart rates using atrial and ventricular pacing. Nitroprusside significantly reduced the AH interval, but it had no effect on the HV interval. Functional and effective refractory periods were measured by the extrastimulus technique. The functional refractory period of the AV node as well as the effective refractory period of the ventriculoatrial conduction system significantly decreased after nitroprusside infusion. This improvement in conduction can probably be explained by the systemic hypotension produced by nitroprusside, which reflexly will increase sympathetic drive to the heart and decrease vagal tone.
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Gould et al. (1979) studied this question.
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