COMPARISON OF THE EFFECTS OF EXERCISE AND ISOPROTERENOL ON THE ANTEGRADE REFRACTORY PERIOD OF THE ACCESSORY PATHWAY IN PATIENTS WITH WOLFF-PARKINSON-WHITE SYNDROME

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The effects of exercise and isoproterenol infusion on the antegrade effective refractory period of the accessory pathway (ERP-AP) were compared in 10 patients with Wolff-Parkinson-White (WPW) syndrome. During an electrophysiologic study, the ERP-AP (paced cycle length: 400 msec) was measured before and during isoproterenol infusion at a rate of 1μg/min. On the next day, a symptom-limited ergometer exercise test was performed and the ERP-AP (paced cycle length: 400 msec) was measured before and during the test using an indwelling atrial electrode catheter. Isoproterenol infusion and the exercise test increased the heart rate from 84±24 to 122±17 beats/min and from 85±25 to 128±25 beats/min, respectively (p=NS isoproterenol versus exercise). The ERP-AP was shortened from 268±34 to 230± 19 msec with isoproterenol infusion (p<0.001) and from 273±42 to 237±31msec with the exercise test (p<0.001). There was no significant difference between the effects of isoproterenol and exercise. The percent change in the ERP-AP with exercise (Y) was significantly correlated to that with isoproterenol infusion (X) (Y=-3.04+0.70X, r=0.92, p<0.001). In conclusion, isoproterenol infusion at the present dose shortens the ERP-AP to the same degree as exercise, and thus is useful for predicting the exercise-induced shortening of the ERP of the accessory pathway in patients with WPW syndrome.
社団法人日本循環器学会の論文
1993-12-20