Martin P
Circ Res. 1977 Jan;40(1):81-9. doi: 10.1161/01.res.40.1.81.
The dynamic interaction of simultaneously changing heart period and single vagal stimuli on atrioventricular conduction (AV interval) was quantified by subtracting the vagally induced responses of the paced heart preparation from those of the unpaced heart preparation. This difference was significantly greater (P less than 0.05) than the AV responses to changes in heart period (delta A) alone without vagal stimulation (using the identical delta AA recorded from the unpaced heart in the same preparation, but with a crushed sinoatrial node). That is, for a given increase in AA interval, the AV conduction time was considerably less when the change in AA was associated with increased vagal activity than in the absence of any vagal activity. Data from some dogs in which a complete AV block was produced for both paced and unpaced hearts suggested that one mechanism of the paradoxical response was located in AV nodal tissue. Data from other dogs, in which two surface atrial recording sites were used, indicated that shifts of pacemaker site and atrial activation patterns also are an important mechanism of the paradoxical response. The relative contribution of these two mechanisms is not fixed, but can vary considerably from animal to animal.
通过从未起搏心脏标本的迷走神经诱发反应中减去起搏心脏标本的迷走神经诱发反应,对同时变化的心动周期和单个迷走神经刺激对房室传导(房室间期)的动态相互作用进行了量化。这种差异显著大于(P小于0.05)无迷走神经刺激时仅心动周期变化(δA)对房室的反应(使用在同一标本的未起搏心脏中记录的相同δAA,但窦房结已被破坏)。也就是说,对于给定的AA间期增加,当AA的变化与迷走神经活动增加相关时,房室传导时间比无任何迷走神经活动时要短得多。一些使起搏和未起搏心脏均产生完全性房室传导阻滞的犬的数据表明,这种矛盾反应的一种机制位于房室结组织。使用两个体表心房记录部位的其他犬的数据表明,起搏点部位的移位和心房激活模式也是矛盾反应的一个重要机制。这两种机制的相对贡献不是固定的,而是在不同动物之间有很大差异。