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Sinus node function in the denervated human heart. Effect of digitalis.

D J Goodman, R M Rossen, R Ingham

    British Heart Journal
    |June 1, 1975
    PubMed
    Summary
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    In heart transplant patients, sinus node function differs from those with intact autonomic systems. Digoxin had minimal effects on innervated hearts but caused conduction blocks in denervated hearts.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Transplant Medicine

    Background:

    • Sinus node function is crucial for heart rhythm.
    • Cardiac autonomic nervous system influences sinus node activity.
    • Heart transplantation results in denervation, altering cardiac physiology.

    Purpose of the Study:

    • To evaluate sinus node function in patients with intact autonomic systems versus those with denervated, transplanted hearts.
    • To assess the effects of digoxin on sinus node function in both patient groups.

    Main Methods:

    • Electrophysiological studies were conducted on 5 patients with intact autonomic systems (Group I) and 8 heart transplant patients (Group II).
    • Studies were repeated after intravenous digoxin administration (1.25 mg) in all Group I and 6 Group II patients.

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  • Key parameters measured included baseline cycle length, sinus node recovery time, and sinoatrial conduction time.

    • Main Results:

    • Baseline sinus node function parameters were initially shorter in transplanted hearts but normalized after heart rate correction.
    • Digoxin showed minimal, non-significant effects on sinus node function in innervated hearts.
    • In denervated hearts, digoxin did not alter cycle length, but caused sinus node exit block in two patients.

    Conclusions:

    • Heart rate correction is essential for comparing sinus node function between innervated and denervated hearts.
    • Digoxin's effects on sinus node function are significantly different in denervated, transplanted hearts compared to innervated hearts.
    • The mechanisms underlying digoxin-induced sinus node conduction abnormalities in denervated hearts require further investigation.