Fourteen patients undergoing routine cardiac catheterisation were paced at a steady frequency; after this test, stimuli were introduced with a variable preceding interval (test pulse interval). The QT interval of the electrocardiogram and the duration of the monophasic action potential of the right ventricle were measured. QT interval is a function of action potential duration; the two variables were very closely correlated in this study. Both these variables increased in duration with increasing test pulse interval. A biphasic response, as previously reported, was not seen. An increase in steady state pacing frequency caused QT interval and action potential duration to decrease for any given R-R interval. When frequency of stimulation was suddenly increased and then maintained, there was an immediate action potential shortening followed by a further more gradual shortening occurring over several minutes. These results imply that a simple correction of QT interval for heart rate (QTc) is inadequate. It is concluded that the relation between action potential duration (or QT interval) and heart rate depends on both the instantaneous interval between beats and the duration of the prevailing heart rate.

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In nine anesthetized and ventilated dogs heart block was induced at thoracotomy, a pacemaker was inserted, and an electromagnetic flow transducer was placed round the main pulmonary artery. The chest was then closed. Stroke volume (SV) was varied by changing central blood volume. Ventilatory dead space (VDS) and alveolar nitrogen mixing efficiency (ANME) were measured at three levels of heart rate (HR) and three levels of SV independently varied during life and also after cessation of heartbeat. Neither VDS nor ANME showed a significant change with HR or SV during life, but mean VDS increased by 43 ml (22%) and mean ANME decreased by 4.4% postmortem. We conclude that cardiac action increases gas mixing at the interface between inspired and resident gas but has only a small effect on gas mixing distal to the interface during respiration without breath holding.

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