Vagal effects on sinoatrial and atrial conduction studied with epicardial mapping in dogs: the influence of pacemaker shifts on the measurement of sinoatrial conduction time

Publisher Website
Google Scholar
Abstract
The influence of pacemaker shifts on sinoatrial conduction time (SACT) was studied by investigating the effects of vagal stimulation on SACT and atrial conduction in anesthetized open-chest dogs. Isochronal maps were drawn from unipolar electrograms simultaneously recorded at 60 epicardial sites on the right atrial free wall and the inferior and superior vena cava. Vagal stimulation caused atrial conduction velocity to increase from 0.99 ± 0.10 m/s (mean ± SD) to 1.23 ± 0.23 m/s (p < 0.01), and the pacemaker to shift to lower positions along the superior vena cava – right atrial junction. As a result of the changes, the distances and the atrial conduction times from the stimulating and recording electrodes to the pacemaker site varied, and hence, the SACT values obtained indirectly by premature atrial stimulation varied. The isochronal maps were used to measure the atrial conduction times from stimulating to recording electrodes (a), from stimulating electrode to pacemaker site (b), and from pacemaker site to recording electrode (c). Indirect SACT was lengthened by vagal stimulation from 43 ± 16 to 64 ± 22 ms (p < 0.02). After correcting by subtracting the atrial conduction time (b + c − a), these values became 26 ± 6 ms (control) and 40 ± 11 ms (vagal stimulation) (p < 0.01). SACT values measured directly from the electrograms were 27 ± 7 ms (control) and 42 ± 10 ms (vagal stimulation) (p < 0.01). Corrected indirect SACTs were closer to direct SACTs than were the uncorrected indirect SACTs. It was concluded that (i) vagal stimulation induced pacemaker shift, increased atrial conduction velocity, and prolonged SACT; (ii) constant atrial pacing induced a pacemaker shift toward the stimulating electrode; and (iii) atrial conduction time must be taken into account to correctly estimate SACT.