The Ventriculophasic Response: Relationship to Sinus Arrhythmia and the Duration of Interposed QRS Complexes
Background The ventriculophasic response (VR) refers to shortening of sinus cycle length during heart block when a QRS complex is interposed between 2 P waves. Our purpose was to analyze its relationship to respiratory sinus arrhythmia (SA) and to compare VR in relation to paced versus intrinsic QRS...
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| Veröffentlicht in: | Annals of noninvasive electrocardiology 2013-07, Vol.18 (4), p.336-343 |
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| creator | Dadu, Razvan T. McPherson, Craig A. |
| description | Background
The ventriculophasic response (VR) refers to shortening of sinus cycle length during heart block when a QRS complex is interposed between 2 P waves. Our purpose was to analyze its relationship to respiratory sinus arrhythmia (SA) and to compare VR in relation to paced versus intrinsic QRS complexes.
Methods
Patients with advanced heart block had their pacer devices temporarily programmed to ventricular inhibited mode at 30 ppm. In 35 subjects, we analyzed VR and SA before, during and after 3 cycles of deep breathing. In 16 other patients we compared VR in the presence of paced versus narrower intrinsic QRS complexes.
Results
The magnitude of P‐P interval shortening surrounding QRS complexes during inspiration correlated with SA (r = 0.36, P = 0.03). The prevalence of VR increased from 37% at baseline to 77% of subjects during deep breathing (P = 0.02). The mean P–P interval shortening was greater surrounding intrinsic QRS complexes than paced QRS complexes (3.6 ± 3.6% vs. 1.4 ± 1.1%, P = 0.02). The prevalence of VR increased from 25% during paced rhythm to 56% when intrinsic complexes were present.
Conclusion
VR, like SA, increases with deep breathing and likely reflects intact parasympathetic nervous system function. Its increase in the presence of narrower beats suggests it may reflect ventricular synchrony. |
| doi_str_mv | 10.1111/anec.12038 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6932283</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1412558623</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4868-f6e3baa33833cfd6092c15a46f373e7742bd7507ec82b8f0d2b8a0e9a5fef2f03</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS0Eou3ChR-ALHFBSCmOncReDkir0JaiVaHdAr1ZXmdMXJI42Al0_z1Ot10BB3ywn-Rvnmf8EHqWksM0rteqA32YUsLEA7Sf5hlNMp5dPYyaCJpwSq720EEI14RQmlH-GO1RJviccraPmssa8BfoBm_12Li-VsFqfAGhd12AN1E1arBR17bHg8Mr240BL7yvN0PdWoVVV-Eherwb_S2IncGn3QC-dwEqfH6xwqVr-wZuIDxBj4xqAjy9O2fo8_HRZfk-WX48OS0Xy0RnohCJKYCtlWJMMKZNVZA51WmussIwzoDzjK4rnhMOWtC1MKSKuyIwV7kBQw1hM_R269uP6xYqPY2nGtl72yq_kU5Z-fdNZ2v5zf2UxZxRGl-doZd3Bt79GCEMsrVBQ9PEr3ZjkGmW0jwXBZ3QF_-g1270XRwvUkU2F4yyqaNXW0p7F4IHs2smJXIKUU4hytsQI_z8z_Z36H1qEUi3wC_bwOY_VnJxdlTemybbGhsGuNnVKP9dFpzxXH49O5Gr83KZfyqE_MB-A-0JuGI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1464983230</pqid></control><display><type>article</type><title>The Ventriculophasic Response: Relationship to Sinus Arrhythmia and the Duration of Interposed QRS Complexes</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Dadu, Razvan T. ; McPherson, Craig A.</creator><creatorcontrib>Dadu, Razvan T. ; McPherson, Craig A.</creatorcontrib><description>Background
The ventriculophasic response (VR) refers to shortening of sinus cycle length during heart block when a QRS complex is interposed between 2 P waves. Our purpose was to analyze its relationship to respiratory sinus arrhythmia (SA) and to compare VR in relation to paced versus intrinsic QRS complexes.
Methods
Patients with advanced heart block had their pacer devices temporarily programmed to ventricular inhibited mode at 30 ppm. In 35 subjects, we analyzed VR and SA before, during and after 3 cycles of deep breathing. In 16 other patients we compared VR in the presence of paced versus narrower intrinsic QRS complexes.
Results
The magnitude of P‐P interval shortening surrounding QRS complexes during inspiration correlated with SA (r = 0.36, P = 0.03). The prevalence of VR increased from 37% at baseline to 77% of subjects during deep breathing (P = 0.02). The mean P–P interval shortening was greater surrounding intrinsic QRS complexes than paced QRS complexes (3.6 ± 3.6% vs. 1.4 ± 1.1%, P = 0.02). The prevalence of VR increased from 25% during paced rhythm to 56% when intrinsic complexes were present.
Conclusion
VR, like SA, increases with deep breathing and likely reflects intact parasympathetic nervous system function. Its increase in the presence of narrower beats suggests it may reflect ventricular synchrony.</description><identifier>ISSN: 1082-720X</identifier><identifier>EISSN: 1542-474X</identifier><identifier>DOI: 10.1111/anec.12038</identifier><identifier>PMID: 23879273</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Arrhythmia, Sinus - diagnosis ; Arrhythmia, Sinus - mortality ; Arrhythmia, Sinus - therapy ; autonomic nervous system ; Cardiac Pacing, Artificial - methods ; Cohort Studies ; Comorbidity ; Defibrillators, Implantable ; Electrocardiography ; Female ; heart block ; Heart Block - diagnosis ; Heart Block - mortality ; Heart Block - therapy ; Humans ; Male ; Original ; Parasympathetic Nervous System - physiopathology ; Prognosis ; Prospective Studies ; Reaction Time ; Risk Assessment ; Severity of Illness Index ; sinus arrhythmia ; Survival Analysis ; Treatment Outcome ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - mortality ; Ventricular Dysfunction, Left - physiopathology ; ventricular synchrony ; ventriculophasic response</subject><ispartof>Annals of noninvasive electrocardiology, 2013-07, Vol.18 (4), p.336-343</ispartof><rights>2013, Wiley Periodicals, Inc.</rights><rights>2013 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4868-f6e3baa33833cfd6092c15a46f373e7742bd7507ec82b8f0d2b8a0e9a5fef2f03</citedby><cites>FETCH-LOGICAL-c4868-f6e3baa33833cfd6092c15a46f373e7742bd7507ec82b8f0d2b8a0e9a5fef2f03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932283/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932283/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27924,27925,45574,45575,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23879273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dadu, Razvan T.</creatorcontrib><creatorcontrib>McPherson, Craig A.</creatorcontrib><title>The Ventriculophasic Response: Relationship to Sinus Arrhythmia and the Duration of Interposed QRS Complexes</title><title>Annals of noninvasive electrocardiology</title><addtitle>Annals of Noninvasive Electrocardiology</addtitle><description>Background
The ventriculophasic response (VR) refers to shortening of sinus cycle length during heart block when a QRS complex is interposed between 2 P waves. Our purpose was to analyze its relationship to respiratory sinus arrhythmia (SA) and to compare VR in relation to paced versus intrinsic QRS complexes.
Methods
Patients with advanced heart block had their pacer devices temporarily programmed to ventricular inhibited mode at 30 ppm. In 35 subjects, we analyzed VR and SA before, during and after 3 cycles of deep breathing. In 16 other patients we compared VR in the presence of paced versus narrower intrinsic QRS complexes.
Results
The magnitude of P‐P interval shortening surrounding QRS complexes during inspiration correlated with SA (r = 0.36, P = 0.03). The prevalence of VR increased from 37% at baseline to 77% of subjects during deep breathing (P = 0.02). The mean P–P interval shortening was greater surrounding intrinsic QRS complexes than paced QRS complexes (3.6 ± 3.6% vs. 1.4 ± 1.1%, P = 0.02). The prevalence of VR increased from 25% during paced rhythm to 56% when intrinsic complexes were present.
Conclusion
VR, like SA, increases with deep breathing and likely reflects intact parasympathetic nervous system function. Its increase in the presence of narrower beats suggests it may reflect ventricular synchrony.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arrhythmia, Sinus - diagnosis</subject><subject>Arrhythmia, Sinus - mortality</subject><subject>Arrhythmia, Sinus - therapy</subject><subject>autonomic nervous system</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Defibrillators, Implantable</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>heart block</subject><subject>Heart Block - diagnosis</subject><subject>Heart Block - mortality</subject><subject>Heart Block - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Original</subject><subject>Parasympathetic Nervous System - physiopathology</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Reaction Time</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>sinus arrhythmia</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - mortality</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>ventricular synchrony</subject><subject>ventriculophasic response</subject><issn>1082-720X</issn><issn>1542-474X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0Eou3ChR-ALHFBSCmOncReDkir0JaiVaHdAr1ZXmdMXJI42Al0_z1Ot10BB3ywn-Rvnmf8EHqWksM0rteqA32YUsLEA7Sf5hlNMp5dPYyaCJpwSq720EEI14RQmlH-GO1RJviccraPmssa8BfoBm_12Li-VsFqfAGhd12AN1E1arBR17bHg8Mr240BL7yvN0PdWoVVV-Eherwb_S2IncGn3QC-dwEqfH6xwqVr-wZuIDxBj4xqAjy9O2fo8_HRZfk-WX48OS0Xy0RnohCJKYCtlWJMMKZNVZA51WmussIwzoDzjK4rnhMOWtC1MKSKuyIwV7kBQw1hM_R269uP6xYqPY2nGtl72yq_kU5Z-fdNZ2v5zf2UxZxRGl-doZd3Bt79GCEMsrVBQ9PEr3ZjkGmW0jwXBZ3QF_-g1270XRwvUkU2F4yyqaNXW0p7F4IHs2smJXIKUU4hytsQI_z8z_Z36H1qEUi3wC_bwOY_VnJxdlTemybbGhsGuNnVKP9dFpzxXH49O5Gr83KZfyqE_MB-A-0JuGI</recordid><startdate>201307</startdate><enddate>201307</enddate><creator>Dadu, Razvan T.</creator><creator>McPherson, Craig A.</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201307</creationdate><title>The Ventriculophasic Response: Relationship to Sinus Arrhythmia and the Duration of Interposed QRS Complexes</title><author>Dadu, Razvan T. ; McPherson, Craig A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4868-f6e3baa33833cfd6092c15a46f373e7742bd7507ec82b8f0d2b8a0e9a5fef2f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arrhythmia, Sinus - diagnosis</topic><topic>Arrhythmia, Sinus - mortality</topic><topic>Arrhythmia, Sinus - therapy</topic><topic>autonomic nervous system</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Defibrillators, Implantable</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>heart block</topic><topic>Heart Block - diagnosis</topic><topic>Heart Block - mortality</topic><topic>Heart Block - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Original</topic><topic>Parasympathetic Nervous System - physiopathology</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Reaction Time</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>sinus arrhythmia</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - mortality</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>ventricular synchrony</topic><topic>ventriculophasic response</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dadu, Razvan T.</creatorcontrib><creatorcontrib>McPherson, Craig A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of noninvasive electrocardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dadu, Razvan T.</au><au>McPherson, Craig A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Ventriculophasic Response: Relationship to Sinus Arrhythmia and the Duration of Interposed QRS Complexes</atitle><jtitle>Annals of noninvasive electrocardiology</jtitle><addtitle>Annals of Noninvasive Electrocardiology</addtitle><date>2013-07</date><risdate>2013</risdate><volume>18</volume><issue>4</issue><spage>336</spage><epage>343</epage><pages>336-343</pages><issn>1082-720X</issn><eissn>1542-474X</eissn><abstract>Background
The ventriculophasic response (VR) refers to shortening of sinus cycle length during heart block when a QRS complex is interposed between 2 P waves. Our purpose was to analyze its relationship to respiratory sinus arrhythmia (SA) and to compare VR in relation to paced versus intrinsic QRS complexes.
Methods
Patients with advanced heart block had their pacer devices temporarily programmed to ventricular inhibited mode at 30 ppm. In 35 subjects, we analyzed VR and SA before, during and after 3 cycles of deep breathing. In 16 other patients we compared VR in the presence of paced versus narrower intrinsic QRS complexes.
Results
The magnitude of P‐P interval shortening surrounding QRS complexes during inspiration correlated with SA (r = 0.36, P = 0.03). The prevalence of VR increased from 37% at baseline to 77% of subjects during deep breathing (P = 0.02). The mean P–P interval shortening was greater surrounding intrinsic QRS complexes than paced QRS complexes (3.6 ± 3.6% vs. 1.4 ± 1.1%, P = 0.02). The prevalence of VR increased from 25% during paced rhythm to 56% when intrinsic complexes were present.
Conclusion
VR, like SA, increases with deep breathing and likely reflects intact parasympathetic nervous system function. Its increase in the presence of narrower beats suggests it may reflect ventricular synchrony.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23879273</pmid><doi>10.1111/anec.12038</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of noninvasive electrocardiology, 2013-07, Vol.18 (4), p.336-343 |
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| source | MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Aged, 80 and over Arrhythmia, Sinus - diagnosis Arrhythmia, Sinus - mortality Arrhythmia, Sinus - therapy autonomic nervous system Cardiac Pacing, Artificial - methods Cohort Studies Comorbidity Defibrillators, Implantable Electrocardiography Female heart block Heart Block - diagnosis Heart Block - mortality Heart Block - therapy Humans Male Original Parasympathetic Nervous System - physiopathology Prognosis Prospective Studies Reaction Time Risk Assessment Severity of Illness Index sinus arrhythmia Survival Analysis Treatment Outcome Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - mortality Ventricular Dysfunction, Left - physiopathology ventricular synchrony ventriculophasic response |
| title | The Ventriculophasic Response: Relationship to Sinus Arrhythmia and the Duration of Interposed QRS Complexes |
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