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January 1, 1982HeartOpen Access

Interrelation of heart rate and autonomic activity in asymptomatic men with unobstructed coronary arteries. Studies with atrial pacing, adrenaline infusion, and autonomic blockade.

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Why the study?

What are the effects of heart rate and autonomic activity on electrocardiographic changes in asymptomatic men with abnormal resting ECGs and normal coronary arteriograms?

Population

Asymptomatic men with abnormal resting electrocardiograms showing changes indistinguishable from those of…

Design

Other

Authors

PTPeter TaggartUniversity College LondonRDR DonaldsonMethodist University HospitalJGJ GreenUniversity of Oxford

Discussion

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Overview

ECG changes mimicking ischemia may reflect independent heart rate or autonomic effects; leaves open relevance to risk stratification or management.

Key Points

  • To distinguish the independent effects of heart rate alone from sympathetic nervous system activity on abnormal resting electrocardiograms in asymptomatic men with angiographically normal coronary arteries.
  • Evaluated asymptomatic male patients presenting with abnormal resting electrocardiograms that mimicked myocardial ischaemia despite verified normal coronary arteriograms.
  • Tested four successive interventions: atrial pacing alone, atrial pacing combined with adrenaline infusion, atrial pacing following beta-blockade, and atrial pacing following combined beta-blockade and atropine.
  • Qualitative assessments distinguished cardiac electrical responses produced directly by artificial heart rate elevation from those modulated by autonomic neurohumoral stimuli.
  • Combined adrenergic stimulation and autonomic blockade modified rate-dependent electrocardiographic alterations independently of intrinsic coronary artery obstruction.

Structured PICO

What are the effects of heart rate and autonomic activity on electrocardiographic changes in asymptomatic men with abnormal resting ECGs and normal coronary arteriograms?

P
Population
Asymptomatic men with abnormal resting electrocardiograms showing changes indistinguishable from those of myocardial ischaemia but with normal coronary arteriograms
I
Intervention
Atrial pacing alone, pacing and adrenaline infusion combined, pacing after beta-blockade, and pacing after beta-blockade plus atropine

This study investigates the physiological mechanisms of ECG abnormalities in asymptomatic men with normal coronary arteries by manipulating heart rate and autonomic tone.

Cite This Study

Taggart et al. (1982) studied this question.

synapsesocial.com/papers/6a85686f37bcb8373dada077https://doi.org/10.1136/hrt.47.1.19
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Paradox of Normal Selective Coronary Arteriograms in Patients Considered to Have Unmistakable Coronary Heart Disease1967 · 414 citations
  2. 2MODE OF ACTION OF AUTONOMIC TRANSMITTERS ON THE HEART1957 · 63 citations
  3. 3Electrocardiographic changes resembling myocardial ischaemia in asymptomatic men with normal coronary arteriograms.1979 · 48 citations
  4. 4Exercise testing after beta-blockade: improved specificity and predictive value in detecting coronary heart disease.1980 · 26 citations
  5. 5Electrocardiographic changes subsequent to artificial ventricular depolarization.1969 · 170 citations