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The effects of exercise and isoproterenol infusion on the antegrade effective refractory period of the accessory pathway (ERP-AP) were compared in 10 patients with Wolff-Parkinson-White (WPW) syndrome. During an electrophysiologic study, the ERP-AP (paced cycle length: 400 msec) was measured before and during isoproterenol infusion at a rate of 1 microgram/min. On the next day, a symptom-limited ergometer exercise test was performed and the ERP-AP (paced cycle length: 400 msec) was measured before and during the test using an indwelling atrial electrode catheter. Isoproterenol infusion and the exercise test increased the heart rate from 84 +/- 24 to 122 +/- 17 beats/min and from 85 +/- 25 to 128 +/- 25 beats/min, respectively (p = NS isoproterenol versus exercise). The ERP-AP was shortened from 268 +/- 34 to 230 +/- 19 msec with isoproterenol infusion (p &lt; 0.001) and from 273 +/- 42 to 237 +/- 31 msec with the exercise test (p &lt; 0.001). There was no significant difference between the effects of isoproterenol and exercise. The percent change in the ERP-AP with exercise (Y) was significantly correlated to that with isoproterenol infusion (X) (Y = -3.04 + 0.70X, r = 0.92, p &lt; 0.001). In conclusion, isoproterenol infusion at the present dose shortens the ERP-AP to the same degree as exercise, and thus is useful for predicting the exercise-induced shortening of the ERP of the accessory pathway in patients with WPW syndrome.

japanese circulation journal

COMPARISON OF THE EFFECTS OF EXERCISE AND ISOPROTERENOL ON THE ANTEGRADE REFRACTORY PERIOD OF THE ACCESSORY PATHWAY IN PATIENTS WITH WOLFF-PARKINSON-WHITE SYNDROME