Autonomic interactions for control of atrial rate are maintained after SA nodal parasympathectomy.

Autonomic control of atrial rate was evaluated in anesthetized dogs by electrical stimulation of stellate ganglia and/or cervical vagi before and after the intrinsic cardiac right atrial ganglionated plexus (RAGP) was injected with the nicotinic blocker hexamethonium or the membrane stabilizing chemical lidocaine, or the RAGP was surgically removed. Injections of lidocaine or hexamethonium into or surgical removal of the RAGP eliminated the bradycardia elicited by vagal stimulation without reducing the tachycardia induced by stellate stimulation. Yet, after surgical ablation of the RAGP, the tachycardia induced by sympathetic stimulation was still reduced by 94% by parasympathetic stimulation. After injections of hexamethonium or lidocaine into the RAGP were administered, the sympathetically induced tachycardia was reduced by 39 and 85%, respectively, by parasympathetic stimulation. After RAGP ablation, when atrial rate was increased by infusion of beta-adrenergic agonists, parasympathetic stimulation reduced atrial rate by 13%. Sinoatrial (SA) nodal parasympathectomy, produced by disrupting the RAGP, eliminates direct vagal control of the SA node while leaving prejunctional parasympathetic projections to sympathetic afferents innervating the SA node intact.