Termination of ventricular tachycardia by an increase in cardiac vagal drive.

MB Waxman, RW Wald - Circulation, 1977 - Am Heart Assoc
MB Waxman, RW Wald
Circulation, 1977Am Heart Assoc
Out of 12 patients in whom phenylephrine terminated ventricular tachycardia, four were
selected for detailed studies of its mechanism of action. Pretreatment with edrophonium (15-
20 mg, iv) decreased, while atropine (2.4 mg, iv) increased by at least a factor of two, the
dose of phenylephrine required to break ventricular tachycardia. Carotid sinus massage
following pretreatment with edrophonium in unusually high (15-20 mg, iv) doses broke
ventricular tachycardia in all four patients. The evidence presented supports the assumption …
Out of 12 patients in whom phenylephrine terminated ventricular tachycardia, four were selected for detailed studies of its mechanism of action. Pretreatment with edrophonium (15-20 mg, i.v.) decreased, while atropine (2.4 mg, i.v.) increased by at least a factor of two, the dose of phenylephrine required to break ventricular tachycardia. Carotid sinus massage following pretreatment with edrophonium in unusually high (15-20 mg, i.v.) doses broke ventricular tachycardia in all four patients. The evidence presented supports the assumption that a vagal mechanism caused both instances of termination. These findings significantly alter our interpretation of vagal interventions in the bedside clinical diagnosis of wide QRS complex tachycardias.
Am Heart Assoc