On the response of ectopic auricular tachycardias to vagus stimulation

Scherf, David; Blumenfeld, Serge; Mueller, Paul S.; Beinfield, William H.

doi:10.1016/0002-8703(53)90011-8

Cited by 19 publications

(5 citation statements)

References 21 publications

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“…Many years earlier the same vagal response was obtained during atrial flutter produced by faradization (Rothberger & Winterberg, 1914). Suppression of the atrial arrhythmia by vagus stimulation in the two conditions was only infrequently obtained (Lewis, Drury & Bulger, 1921 ;Scherf & Terranova, 1949;Scherf, Blumenfeld, Mueller & Beinfield, 1953). It was on the basis of these observations that the aconitine-induced arrhythmia was classified as atrial flutter as distinct from paroxysmal tachycardia.…”

Section: Discussionmentioning

confidence: 82%

Suppression of Ouabain‐induced Atrial Arrhythmias by Carotid Sinus Stimulation

Schott

1961

British Journal of Pharmacology and Chemotherapy

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In dogs anaesthetized with chloralose ectopic atrial arrhythmias were produced by subepicardial injection of ouabain. Stimulation of the right carotid sinus abruptly suppressed the ectopic arrhythmias. They returned on cessation of stimulation and sometimes already during the period of stimulation. It is suggested that in view of its response to carotid sinus stimulation the ouabain-induced arrhythmia resembles paroxysmal atrial tachycardia and that it is distinct from the aconitine-induced arrhythmia which on account of its response to vagal stimulation has been classified as atrial flutter.It is well known to clinicians that attacks of atrial paroxysmal tachycardia can often be terminated by carotid sinus pressure whereas this procedure is ineffective in atrial flutter. It is equally well known that different types of atrial arrhythmias can be produced in animals by local application of various drugs to the epicardial surface of the heart (Scherf, 1944(Scherf, , 1947Kisch, 1944;Scherf & Chick, 1951;Prinzmetal, Corday, Brill, Oblath & Kruger, 1952;Scherf, Blumenfeld, Taner & Yildiz, 1960), but it has never been shown that any of these resemble paroxysmal atrial tachycardia in man by the crucial test of being consistently suppressible by means of carotid sinus stimulation. It has now been found that the arrhythmia produced by subepicardial injection of ouabain is regularly susceptible to carotid sinus stimulation. METHODSDogs weighing between 9 and 14 kg were premedicated with morphine, 1 mg/kg injected subcutaneously, and anaesthetized with chloralose, 0.1 g/kg injected intravenously. The blood pressure was recorded from a femoral artery and a cannula was inserted into the trachea.In all experiments stimulation of the carotid sinus was carried out on the right side with both sinus and aortic nerves intact in order to approximate the effects obtained in man, where pressure on the right carotid sinus is more frequently effective in terminating attacks of atrial paroxysmal tachycardia (Scherf & Schott, 1953). The right carotid sinus was exposed, and stimulating shielded platinum electrodes were applied to the dissected sinus nerve and connected to a transistor stimulator (Joslin, 1959). Stimulation was carried out with impulses of 15 V, 1 msec, 100/sec. In a few experiments the innervated right carotid sinus was isolated, according to the method of Moissejeff (1927), making possible its distension by introducing liquid into it, and at the same time recording the intrasinusal pressure.After dissection of the carotid sinus, the sternum was split, the chest opened in the midline to expose the heart, while artificial respiration was given with a Starling (" Ideal ") pump.

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Section: Discussionmentioning

confidence: 82%

Suppression of Ouabain‐induced Atrial Arrhythmias by Carotid Sinus Stimulation

Schott

1961

British Journal of Pharmacology and Chemotherapy

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“…a-3 7P 8P PROCEEDINGS OF THE PHYSIOLOGICAL refractory period and a prolonged conduction time for their perpetuation. This will also explain why both respond to vagal stimulation by an increase of rate, a fact which proponents of ectopic focus theory find difficult to explain (Scherf, Blumenfeld, Mueller & Beinfield, 1953 Bhattacharya, Feldberg & Vogt (1957) found a factor in normal cerebrospinal fluid (c.s.f.) which sensitized the frog rectus muscle to acetylcholine.…”

Section: Kinetic Evidence For Variations Of Interaction In the Reactionsmentioning

confidence: 92%

Proceedings of the Physiological Society, 27–28 April 1962, Plymouth Meeting: Communications

1962

The Journal of Physiology

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“…Scherf and his associates (29) object to this complicated ex planation that if it were true the cessation of atrial tach y arrh y th mias during vagal stim ulation should be preceded In' an increase of the rate, whereas the tracings reported by Lewis point rather to a slowing of the rate of the last ectopic waves. Furtherm ore, the circus movement theory itself, greatly invalidated by Condorelli's (5, 6) classical investigations on partial fibrillation, has been criticized by m any researchers (2,18,22,23,26,27,28).…”

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confidence: 99%

“…And yet even in this connection the opposite is occasionally true and vagal stim u lation m ay instead term inate the arrhythm ia. Such contrasting effects of vagal stim ulation m ay be observed regardless of whether the flutter has been induced by electric stim ulation of the atria (13), or by the local application of aconitine (29).…”

mentioning

confidence: 99%

“…At the present time most authors uphold that atrial flutter and fi brillation are the result of high-rate stimuli form ation in one or more ectopic centres located in the atria. Scherf (29), however, suggests that, at least in Ihe case of aconitine-induced flutter, there m ay be a continuous stim ulus to which the atrial m yocardium responds at varying rates depending on the duration of the re fractory period. Therefore "the increase of the ectopic auricular rate during vagal stim ulation could be attributed to one of the following two m echanism s: (1) an increase in rate of stim ulus form ation or (2) a shortening of the refractory period leading to a more rapid response to a continuous stim ulus".…”

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confidence: 99%

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