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European Heart Journal 1986 7(4):334-340;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Inhibitory effect of acute and chronic administration of digitalis on the sick sinus node

R. BOLOGNESI, G. BENEDINI, R. FERRARI and O. VISIOLI

Cattedra di Cardiologia, Universita'degli Studidi Parma, and Cattedra di Cardiologia, Universita' degli Studi di Brescia Italy

Received 29 March 1985; revised 28 November 1985; .

Address for correspondence and reprints: Dr Bolognesi Roberto, Cattedra di Cardiologia, Universita' degli Studi di Parma, Via Gramsci, 14, 43100 Parma, Italy

Abstract

We have determined the effects of the acute administration of intravenous (i.v.) digitalis administration (0.8 mg of digoxin in 5–10 min) on the electrophysiological variables of 12 normal subjects (group 1), 12 patients with asymptomatic sinus node bradycardia (group 2) and 34 patients with symptomatic sinus node dysfunction (SSS) (group 3). The injection of digitalis induced: (1) an increase of sinus node cycle length (SNCL) in all groups; (2) a 10% increase of sinus node recovery time (SNRT) in group 1, no changes in group 2 and a 25% increase in group 3; (3) a tendency to increase, without reaching statistical significance, of corrected sinus node recovery time (CSNRT) and sino-atrial conduction time (SACT) in all groups. In 16 patients of group 3 the effects of oral chronic treatment with digoxin (0.25 mg daily for 7 days) was also determined. The results show that chronic treatment did not further affect SNCL, SNRT or CSNRT, but caused a greater increase of SACT than did the acute i.v. administration. Chronic treatment significantly reduced the sinus rate and increased the number of premature supraventricular and ventricular beats, measured by means of 24 hour-Holter monitoring.

Key Words: Digitalis • sick sinus syndrome • electrophysiology • Holter ecg monitor recording


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