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Effect of Transdermal Scopolamine on Heart Rate Variability in Patients with Severe Coronary Heart Disease
Author(s) -
KOCHIADAKIS GEORGE E.,
ROMBOLA AMALIA T.,
KANOUPAKIS EMMANUEL M.,
ZURIDAKIS EMMANUEL G.,
SKALIDIS EMMANUEL I.,
VARDAS PANOS E.
Publication year - 1996
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1996.tb03242.x
Subject(s) - medicine , heart rate variability , cardiology , heart rate , holter monitor , depression (economics) , anesthesia , electrocardiography , blood pressure , economics , macroeconomics
A decrease in cardiac parasympathetic tone is a recognized finding in patients with ischemia heart disease, correlating closely with disease severity and overall survival. The aim of this study was to assess whether transdermal Scopolamine (Tds), which increases parasympathetic tone in healthy volunteers, increases vagal tone in patients with severe CAD and whether it might have an antiischemic effect. Fifteen patients (10 men, aged 55 ± 8 years) with three‐vessel CAD, but with no prior MI and preserved ventricular function, underwent 24‐hour Holter monitoring and exercise testing before and after wearing a Scopolamine patch for 24 hours. Time‐domain measures of heart rate variability (HRV) and the total number and duration of ischemic episodes were obtained from the Holter recordings for each patient. Tds significantly (P < 0.05) increased the values of all HRV measures. Tds also reduced the total number of ischemic episodes (from 273 to 159, P < 0.05) and their total duration (from 136 to 46 min per patient, P < 0.05). Tds also increased treadmill exercise duration from 293 ± 101 to 345 ± 95 seconds (P <0.05) and the time to 1‐mm ST depression from 177 ± 105 to 244 ± 128 seconds (P < 0.02), while maximum ST depression was reduced from 2.86 ± 0.6 to 2.3 ± 0.3 (P < 0.05). No significant side effects were observed. Tds modifies the autonomic balance in patients with severe CAD toward a condition associated with a better prognosis. It may also be useful as an adjunctive treatment for ischemic heart disease.