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Not to be confused with Chronotype or Chronotope.

Chronotropic effects (from chrono-, meaning time, and tropos, "a turn") are those that change the heart rate.

Chronotropic drugs may change the heart rate and rhythm by affecting the electrical conduction system of the heart and the nerves that influence it, such as by changing the rhythm produced by the sinoatrial node. Positive chronotropes increase heart rate; negative chronotropes decrease heart rate.

A dromotrope affects atrioventricular node (AV node) conduction. A positive dromotrope increases AV nodal conduction, and a negative dromotrope decreases AV nodal conduction. A lusitrope is an agent that affects diastolic relaxation.

Many positive inotropes affect preload and afterload.

Positive chronotropes

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Negative chronotropes

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Chronotropic variables can be considered in systolic myocardial left and right sides. Left sided systolic chronotropy can be appreciated as Aortic Valve open to close time. Right sided variables are represented by pulmonary valve open to close time. Inverted as diastolic chronotropy, the variables are aortic valve close to open and pulmonic close to open time. Pharmaceutical manipulation of chronotropic properties was perhaps first appreciated by the introduction of digitalis, though it turns out that digitalis has an inotropic effect rather than a chronotropic effect.

References

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  1. ^ Alboni, P.; Menozzi, C.; Brignole, M.; Paparella, N.; Gaggioli, G.; Lolli, G.; Cappato, R. (1997). "Effects of Permanent Pacemaker and Oral Theophylline in Sick Sinus Syndrome: The THEOPACE Study: A Randomized Controlled Trial". Circulation. 96 (1): 260–266. doi:10.1161/01.CIR.96.1.260. PMID 9236443.
  2. ^ DiFrancesco, D. (2020). "A Brief History of Pacemaking". Frontiers in Physiology. 10 1599. doi:10.3389/fphys.2019.01599. PMC 6987461. PMID 32038284.


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Chronotropic incompetence

Chronotropic incompetence (CI) is the inability of heart rate to increase as expected in response to exercise. The condition can be defined in different

Diltiazem

ventricular function may not be able to counteract the negative inotropic and chronotropic effects of diltiazem, the result being an even higher compromise of function

Tachycardia-induced cardiomyopathy

cardiomyopathy, tachycardia-mediated cardiomyopathy, tachymyopathy, chronotropic cardiomyopathy, tachycardiomyopathy Pronunciation tak-i-kahr-dee-uh in-dyoos-duh

Beta blocker

result from negative chronotropic and inotropic effects, which decrease cardiac workload and oxygen demand. Negative chronotropic properties of beta blockers

Cocaine

cocaine at a constant blood concentration, the acute tolerance to the chronotropic cardiac effects of cocaine begins after about 10 minutes, while acute

Ischemia

blood flow to the heart and are prescribed with medications that reduce chronotropic and inotropic effect to meet the new level of blood delivery supplied

Calcium channel blocker

in a negative chronotropic effect, or a lowering of heart rate. This can increase the potential for heart block. The negative chronotropic effects of CCBs

Bradycardia

than expected in a particular disease state, often a febrile illness. Chronotropic incompetence (CI) refers to an inadequate rise in heart rate during periods