Contraction-excitation feedback in the atria: A cause of changes in refractoriness

Shunichi Kaseda, Douglas P. Zipes

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

The purpose of this study was to investigate the immediate effects of an increase in atrial pressure on atrial refractoriness by determining the relation between the atrial pressure and effective refractory period of the atrium. In 21 open chest anesthetized dogs, after the blocking of atrioventricular (AV) conduction by formalin injection, the left atrium and left ventricle were paced sequentially at a fixed cycle length of 300 ms. The AV interval was varied from 0 to 280 ms in 20 ms steps during the recording of aortic and left atrial pressures and refractory period of the left atrium. Mean left atrial pressure was lowest (8.0 ± 0.4 mm Hg, all values mean ± SEM) at an AV interval of 47 ± 3 ms, when refractory period was 135.5 ± 2.6 ms. Mean left atrial pressure was highest (13.3 ± 0.5 mm Hg) at an AV interval of 147 ± 5 ms, when refractory period was 137.9 ± 2.4 ms (p < 0.01). Left atrial diameter measured by echocardiography increased from 33.7 ± 1.8 mm at an AV interval of 47 ms to 37.8 ± 1.8 mm (p < 0.01, n = 10) at an AV interval of 147 ms, and mean aortic pressure decreased from 109 ± 4 to 101 ± 4 mm Hg. After surgical decentralization of vagal and sympathetic innervation to eliminate baroreflex influence on refractoriness, left atrial refractory period prolonged from 141.6 ± 3.4 to 145.4 ± 3.4 ms (p < 0.01) when mean left atrial pressure increased from 9.5 ± 0.4 to 15.2 ± 0.6 mm Hg. A similar relation was noted between right atrial pressure and right atrial refractory period (n = 10) and between left atrial pressure and refractory period of the interatrial septum (n = 12). In six chronically instrumented conscious dogs, left atrial refractory period prolonged from 116.3 ± 2.3 to 124.2 ± 1.7 ms (p < 0.01) when mean left atrial pressure increased from 4.0 ± 0.8 to 9.0 ± 0.3 mm Hg. Therefore, an increase in atrial pressure lengthens refractory period of both atria and the interatrial septum in anesthetized and conscious dogs.

Original languageEnglish (US)
Pages (from-to)1327-1336
Number of pages10
JournalJournal of the American College of Cardiology
Volume11
Issue number6
DOIs
StatePublished - Jun 1988

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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