Key result
Reflex vagal activation via phenylephrine cuts VPCs by ~99% in responders.
Why the study?
The antiarrhythmic effect of reflex-induced vagal activation on frequency of ventricular premature complexes and the role of heart rate reduction in suppressing VPCs were not well established.
Does reflex vagal activation via phenylephrine infusion reduce the frequency of ventricular premature complexes in patients with frequent VPCs?
Population
17 patients with frequent ventricular premature complexes
Comparison
Phenylephrine-induced reflex vagal activation with and without atrial pacing vs control conditions
Design
Interventional study with phenylephrine infusion and atrial pacing
Authors
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Should not change VPC management; leaves open therapeutic role of reflex vagal activation pending controlled trials.
Does reflex vagal activation via phenylephrine infusion reduce the frequency of ventricular premature complexes in patients with frequent VPCs?
Absolute Event Rate: 0.2% vs 38%
p-value: p=<0.0001
Reflex vagal activation markedly reduces ventricular premature complexes, an effect that is only partially rate-dependent.
Facchini et al. (1991) studied Frequent ventricular premature complexes (VPCs) (n=17). Phenylephrine infusion (reflex vagal activation) vs. Control conditions (preinfusion levels) was evaluated on Mean number of ventricular premature complexes (VPCs) per 100 beats (p=<0.0001). Reflex vagal activation via phenylephrine infusion markedly reduced the mean number of ventricular premature complexes from 38 to 0.2 per 100 beats in responders (p<0.0001).