{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:35:48Z","timestamp":1761561348130},"reference-count":43,"publisher":"American Physiological Society","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American Journal of Physiology-Heart and Circulatory Physiology"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:p> Depressed parasympathetic activity has been proposed to be associated with an increased risk of sudden death. Parasympathetic effects (PE) on cardiac electrophysiology during exercise and recovery have not been studied in patients with left ventricular dysfunction. We performed noninvasive electrophysiological studies (NI-EPS) and characterized the electrophysiological properties of the sinus node, atrioventricular (AV) node, and ventricle in subjects with depressed left ventricular ejection fraction and dual-chamber defibrillators. NI-EPS were performed during rest, exercise, and recovery at baseline and after parasympathetic blockade with atropine to assess PE (the difference between parameter values in the 2 conditions). Ten subjects (9 men: age, 60 \u00b1 9 yr; and left ventricular ejection fraction, 29 \u00b1 8%) completed the study. All NI-EPS parameters decreased during exercise and trended toward rest values during recovery. PE at rest, during exercise, and during recovery, respectively, were on sinus cycle length, 320 \u00b1 71 ( P = 0.0001), 105 \u00b1 60 ( P = 0.0003), and 155 \u00b1 82 ms ( P = 0.0002); on AV block cycle length, 137 \u00b1 136 ( P = 0.09), 37 \u00b1 19 ( P = 0.002), and 61 \u00b1 39 ms ( P = 0.006); on AV interval, 58 \u00b1 32 ( P = 0.035), 22 \u00b1 13 ( P = 0.002), and 36 \u00b1 20 ms ( P = 0.001); on ventricular effective refractory period, 15.8 \u00b1 11.3 ( P = 0.02), 4.7 \u00b1 15.2 ( P = 0.38), and 6.8 \u00b1 15.5 ms ( P = 0.20); and on QT interval, 13 \u00b1 12 ( P = 0.13), 3 \u00b1 17 ( P = 0.6), and 20 \u00b1 23 ( P = 0.04). In conclusion, we describe for the first time the changes in cardiac electrophysiology and PE during rest, exercise, and recovery in subjects with left ventricular dysfunction. PEs are preserved in these patients. Thus the role of autonomic changes in the pathophysiology of sudden death requires further exploration. <\/jats:p>","DOI":"10.1152\/ajpheart.00193.2009","type":"journal-article","created":{"date-parts":[[2009,6,13]],"date-time":"2009-06-13T01:42:58Z","timestamp":1244857378000},"page":"H743-H749","source":"Crossref","is-referenced-by-count":6,"title":["Parasympathetic effects on cardiac electrophysiology during exercise and recovery in patients with left ventricular dysfunction"],"prefix":"10.1152","volume":"297","author":[{"given":"Alexandru B.","family":"Chicos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prince J.","family":"Kannankeril","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan H.","family":"Kadish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Goldberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"24","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011093431902"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1982.03320370021023"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.69.2.250"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90106-B"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(89)90871-0"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)11181-9"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910283411804"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-7-200004040-00007"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.67.2.129"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.3.945"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198403293101306"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.53.3.450"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)91029-6"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.3.842"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.3.1068"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00783-6"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00825.2001"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(87)90795-8"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.6.1507"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11144-8"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.01.038"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00635-3"},{"key":"R23","unstructured":"Maciel BC, Gallo L Jr, Marin-Neto JA, Terra-Filho J, Manco JC. 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