TY - JOUR
T1 - Exercise response before and after termination of atrial tachycardia after congenital heart disease surgery
AU - Wessel, H. U.
AU - Benson, D. W.
AU - Braunlin, E. A.
AU - Dunnigan, A.
AU - Paul, M. H.
PY - 1989
Y1 - 1989
N2 - We studied exercise performance before and after conversion of atrial tachycardia to sinus rhythm, atrial bradycardia, or junctional rhythm in 10 patients 9-25 years of age 8-20 years after congenital heart disease surgery (complete transposition of the great arteries, seven of 10 patients). The same maximal cycle (five of 10 patients) or treadmill (five of 10 patients) exercise protocol was performed in atrial tachycardia and sinus rhythm 1-232 days after atrial tachycardia (mean, 34 days). Electrocardiogram, heart rate, and pulmonary gas exchange were recorded. Sinus rhythm exercise increased peak V̇O2 (mean, 28.7 [sinus rhythm] vs. 24.7 [atrial tachycardia], p < 0.01), exercise time (p < 0.01), and O2 pulse at rest (p < 0.01) and at peak exercise (NS). Mean resting heart rate decreased from 109 to 70 beats/min (p < 0.01). In atrial tachycardia, peak exercise heart rate was low (80-163 beats/min) because of fixed conduction (six of 10 patients) or high as conduction approached 1:1 (176-252 beats/min) (four of 10 patients). In sinus rhythm, rest to peak exercise heart rate increased in six of 10 patients (p < 0.05). The data show improved exercise performance in sinus rhythm primarily because of improved heart rate adaptation to exercise, by either permitting increased heart rate response or eliminating excessively high heart rate with inadequate diastolic filling.
AB - We studied exercise performance before and after conversion of atrial tachycardia to sinus rhythm, atrial bradycardia, or junctional rhythm in 10 patients 9-25 years of age 8-20 years after congenital heart disease surgery (complete transposition of the great arteries, seven of 10 patients). The same maximal cycle (five of 10 patients) or treadmill (five of 10 patients) exercise protocol was performed in atrial tachycardia and sinus rhythm 1-232 days after atrial tachycardia (mean, 34 days). Electrocardiogram, heart rate, and pulmonary gas exchange were recorded. Sinus rhythm exercise increased peak V̇O2 (mean, 28.7 [sinus rhythm] vs. 24.7 [atrial tachycardia], p < 0.01), exercise time (p < 0.01), and O2 pulse at rest (p < 0.01) and at peak exercise (NS). Mean resting heart rate decreased from 109 to 70 beats/min (p < 0.01). In atrial tachycardia, peak exercise heart rate was low (80-163 beats/min) because of fixed conduction (six of 10 patients) or high as conduction approached 1:1 (176-252 beats/min) (four of 10 patients). In sinus rhythm, rest to peak exercise heart rate increased in six of 10 patients (p < 0.05). The data show improved exercise performance in sinus rhythm primarily because of improved heart rate adaptation to exercise, by either permitting increased heart rate response or eliminating excessively high heart rate with inadequate diastolic filling.
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U2 - 10.1161/01.CIR.80.1.106
DO - 10.1161/01.CIR.80.1.106
M3 - Article
C2 - 2736742
AN - SCOPUS:0024339998
SN - 0009-7322
VL - 80
SP - 106
EP - 111
JO - Circulation
JF - Circulation
IS - 1
ER -