The Effects of Propranolol on Cardiac Conduction

Abstract

The effects of propranolol, 0.1 mg/kg given intravenously, on atrioventricular (A-V) conduction and intraventricular (IV) conduction were studied in eight patients. Atrial pacing was used to control the heart rate. His bundle electrograms were recorded, and the interval from the pacing impulse to the His bundle electrogram (P-H interval) was used as a measure of A-V conduction and the interval from the His bundle electrogram to the S wave (H-S interval) was used as a measure of intraventricular conduction. Propranolol significantly prolonged the P-H interval in every patient at all paced heart rates, and it had no effect on the H-S interval. In two patients propranolol prolonged the effective refractory period of the atrioventricular conducting tissue. In four dogs during His bundle pacing, propranolol (4 mg/kg iv) had no effect on intraventricular conduction as measured from the His bundle pacing spike to S wave (H-S interval). In two dogs with prolonged H-S intervals secondary to toxic doses of digitalis and procainamide, propranolol had no effect on IV conduction. It is concluded that propranolol prolongs A-V conduction and has no effect on IV conduction when administered to patients in clinically effective dosages. Propranolol's effects on cardiac conduction can be explained on the basis of its capacity to produce beta-adrenergic blockade.