Voltage- and rate-dependent depression of Vmax of action potentials by a new antiarrhythmic agent, E-0747, in swine cardiac Purkinje fibers

Effects of a new antiarrhythmic agent, E-0747, on action potentials of swine cardiac Purkinje fibers were studied using standard microelectrode techniques. E-0747 decreased the maximum rate of rise (Vmax) of action potentials at concentrations higher than 3 X 10(-7) M at a frequency of 1 Hz without change in resting membrane potential. E-0747 (3 X 10(-6) M) shifted the steady-state relationship between the Vmax and the resting membrane potential in a hyperpolarizing direction by 9.2 +/- 0.9 mV. E-0747 depressed the Vmax in a rate-dependent manner. At a concentration of 3 X 10(-6) M, the depression was approximately 50% at a stimulation of 3.3 Hz. E-0747 (3 X 10(-6) M) did not depress the Vmax of the first action potential after a rest period of approximately 30 min, but subsequently reduced the Vmax with successive stimulations reaching a new steady level after approximately 20 min. The time course of recovery from inactivation of the Vmax in the presence of E-0747 (10(-6) M) did not differ from that of the control. E-0747 shortened the action potential duration (APD), but did not affect the ratio of effective refractory period (ERP) to APD. These results suggest that E-0747 depresses the Vmax by closely associating with open and/or inactivated sodium channels. It may be classified as an antiarrhythmic agent of class 1C type of the Vaughan Williams' classification.

Slow inactivation of the sodium current in rabbit cardiac Purkinje fibres

An analysis of the slowly inactivating Na current in rabbit cardiac Purkinje fibres was made, using the two-microelectrode voltage clamp technique. The existence of the slowly inactivating Na current was demonstrated by recording TTX-sensitive currents. The current was sensitive to Na withdrawal and could be blocked by 0.1 mM Cd. The current-voltage relation extended over a broad range of potentials, as negative as -85 mV. The time course of inactivation consisted of different phases, with time constants differing as much as three orders of magnitude. Time constants of the first phase of slow inactivation increased at more positive potentials. Non-inactivating Na currents were observed in the threshold region. Recovery from inactivation was less complex. The voltage dependency of inactivation could be described by a sigmoidal curve with a half maximum potential of -75.6 mV and a slope factor of 6.3 mV. Deactivation was fast. The results suggest that at the microscopic level the Na channel shows multiple states of inactivation. At the macroscopic level the slowly inactivating Na current plays an important role in determining diastolic potential, pacemaker activity and plateau duration, and is fundamental in explaining the effect of local anesthetics and frequency of stimulation on action potential duration.

Triggered activity induced by combined mild hypoxia and acidosis in guinea-pig Purkinje fibers

The effects of prolonged exposure to combined mild hypoxia (Po2 230 +/- 20 mmHg) and acidosis (pH: 6.8 +/- 0.05) were studied in guinea-pig left ventricular myocardium superfused in vitro. Only Purkinje fibers were impaled by microelectrodes. Triggered activity developed in depolarized Purkinje fibers after 48 +/- 9 min of exposure to hypoxic and acid conditions and was initiated either by short periods of rapid electrical driving or by the background slow Purkinje automaticity. Triggered activity occurred when a delayed afterdepolarization attained its threshold potential and terminated after a subthreshold afterdepolarization. Interaction between triggered activity and slow background automaticity was observed until 90 to 180 min of exposure to hypoxic and acid conditions. These effects were reversed by replacement in standard conditions (Po2 510 +/- 20 mmHg; pH 7.35 +/- 0.05). Norepinephrine (1 X 10(-6)M) significantly accelerated the rate of discharge of triggered foci and led to a stable sustained triggered activity. Increasing extracellular Ca2+ concentration aggravated the effects of combined mild hypoxia and acidosis and led to the occurrence of early afterdepolarizations initiating triggered activity. In addition abnormal automaticity developed in quiescent fibers without any triggering action potential. Lidocaine and verapamil suppressed the triggered activity following a subthreshold afterdepolarization. Their effects were reversed on wash-out. It is concluded that prolonged exposure to combined mild hypoxia and acidosis induces triggered activity by a basic mechanism common to other situations leading to a calcium overload and showing such behaviour.

Effects of Ca2+/Mg2+ removal on aiNa, aiK, and tension in cardiac Purkinje fibers

Sheep cardiac Purkinje fibers were exposed to solutions free of divalent cations for hour-long periods, while intracellular Na+ and K+ activities were measured using ion-sensitive microelectrodes. Intracellular Na+ activity (aiNa) increased to 50.1 +/- 8.1 mM, and intracellular K+ activity (aiK) decreased to 76.7 +/- 3.5 mM. These ionic changes could be blocked by the presence of Mg2+ or the Ca2+ channel blocking agents D 600 and nifedipine. The rise in aiNa and the fall in aiK was accentuated by the inhibition of the Na+-K+ pump with acetylstrophanthidin or by removal of extracellular K+. These results demonstrate that in cardiac Purkinje fibers removal of divalent cations produces intracellular loading of Na+ by Na+ entry through the Ca2+ channel. On reexposure to Ca2+-containing solutions, the cells become loaded with Ca2+, and the fibers exhibit large contractures. These observations implicate Na+-Ca2+ exchange in the entry of Ca2+ into these cells during Ca2+ repletion and in the etiology of the calcium paradox.

Electrophysiological effects of acetyl glyceryl ether phosphorylcholine on cardiac tissues: comparison with lysophosphatidylcholine and long chain acyl carnitine

Electrophysiological effects of synthetic platelet activating factor, acetyl glyceryl ether phosphorylcholine (AGEPC), were examined and compared with those of lysophosphatidylcholine (LPC) and long chain acyl carnitine (AC) in canine Purkinje fibres and guinea-pig papillary muscles, by use of standard microelectrode techniques. In canine Purkinje fibres, AGEPC at concentrations higher than 3 X 10(-5)M, decreased maximum diastolic potential, action potential amplitude and the maximum upstroke velocity of phase 0. AGEPC also induced abnormal automaticity arising from depolarized membrane potentials. LPC and AC in concentrations higher than 3 X 10(-5)M also produced virtually identical electrophysiological alterations in Purkinje fibres. Although twitch tension was slightly decreased by low concentrations (10(-6)-10(-5)M) of these amphiphilic lipids, a transient positive inotropic response appeared at the beginning of a progressive depolarization after exposure to higher concentrations of the amphiphiles. In guinea-pig papillary muscles, AGEPC in concentrations higher than 3 X 10(-5)M produced slight decreases in resting membrane potential, action potential amplitude and action potential durations, concomitantly with a positive inotropic response. These electrophysiological and mechanical changes were also induced by LPC and AC at comparable concentrations. In guinea-pig papillary muscles depolarized with 25 mM [K+]0, AGEPC, LPC and AC all evoked slow action potentials at a concentration of 10(-4)M. It is concluded that in isolated cardiac tissues AGEPC exerts electrophysiological effects similar to those of LPC and AC only at high concentrations, and that the non-specific interaction of amphiphiles with sarcolemmal membrane may be responsible for the electrophysiological and mechanical effects.

A proposed mechanism for cardiac sensitisation: electrophysiological study of effects of difluorodichloromethane and adrenaline on different types of cardiac preparations isolated from sheep hearts

Difluorodichloromethane (FC12) inhaled at high concentrations sensitises, as do numerous other volatile organic compounds, mammalian heart to adrenaline induced arrhythmias. In this study three types of cardiac tissue (spontaneously beating sinusal and Purkinje preparations and stimulated Purkinje fibres) were isolated from sheep hearts and perfused for electrophysiological recording to examine the effect of FC 12. Preparations were perfused alternately with a control solution of physiological fluid and a trial solution with dissolved FC 12, the partial pressure of oxygen remaining identical. Sensitisation to adrenaline was studied by injecting adrenaline at a dose causing a notable effect without producing arrhythmias in the control preparations. Examination of transmembrane potential recordings confirmed that FC 12 inhibits sinus node pacemaker stimulation by adrenaline. Conversely, the adrenaline induced acceleration of latent pacemakers in certain types of Purkinje fibres appeared to be potentialised by FC 12. The various types of arrhythmia observed in vitro were explained by the effect of FC 12 on cell membranes, an affect which can oppose or favour that of adrenaline. These phenomena explain the arrhythmias observed in isolated hearts or whole animal preparations and permit a better understanding of the mechanism involved in cardiac sensitisation to adrenaline induced arrhythmia, a mechanism in which variability in time and location is the essential factor in the FC 12 effect.

Depolarizing effects of catecholamines in quiescent sheep cardiac Purkinje fibers

Isoproterenol reversibly depolarizes quiescent sheep cardiac Purkinje fibers, in contrast to its reported hyperpolarizing effect in many excitable tissues. The depolarization is inhibited by drugs that block beta 1-adrenergic receptors. Tetrodotoxin and verapamil have no effect on the isoproterenol-induced depolarization. Cesium reduced the isoproterenol-induced depolarization by 74%. The voltage dependency of activation of a current component called If, measured under voltage clamp, was shifted in the depolarizing direction by isoproterenol. No evidence was found to support the suggestion made for other tissues that the Na+-K+ pump is stimulated by isoproterenol. These data suggest that in quiescent sheep Purkinje fibers the isoproterenol-induced depolarization reflects activation of a pacemaker current.

Studies on bethanidine and meobentine: direct and indirect effects of antifibrillatory drugs

The electrophysiological effects of bethanidine and meobentine were studied on isolated canine cardiac tissues and the in situ dog heart using standard techniques. The "direct" electrophysiological effects of bethanidine (in the beta-adrenergic-blocked Purkinje fiber) resemble the effects of meobentine in the normal canine Purkinje fiber; both drugs produce use-dependent decreases of the maximum rate of depolarization of phase 0 and action potential amplitude. In addition, meobentine prolongs action potential duration (100%) of Purkinje fibers. In ventricular muscle cells, the only significant effect of meobentine is a decrease in the maximum rate of depolarization. In studies of ouabain-induced tachycardias and 24-h infarct-induced ventricular arrhythmias, bethanidine tends to increase heart rate and/or exacerbate the ectopic activity (due to its sympathomimetic effects), whereas meobentine tends to reduce heart rate and restore normal sinus rhythm. Both bethanidine and meobentine increase ventricular fibrillation threshold. This increase is evident following bethanidine injection after the subsidence of the sympathomimetic effects. Finally, moderate increases of ventricular fibrillation threshold following treatment with meobentine are accompanied by partial cardiac sympathetic blockade, as indicated by reduced chronotropic responses to stellate ganglion stimulation. The antiarrhythmic and antifibrillatory effects of bethanidine and meobentine may be explained by the use-dependent effects of these drugs on phase 0 of the action potential and by their sympatholytic actions on the autonomic nervous system. Meobentine may, in addition, exert antiarrhythmic effects by decreasing automaticity in partially depolarized cells.

Comparative electrophysiological effects of disopyramide and bepridil on rabbit atrial, papillary, and Purkinje tissue: modification by reduced extracellular potassium

The electrophysiological actions of bepridil were compared with those of disopyramide in rabbit atrial, Purkinje, and papillary muscles in both normokalaemic (5.6 mM K+) and low K+ medium. In normokalaemic medium, the major electrophysiological effects of bepridil (10-40 microM) were a reduction in the maximum rate of rise of phase 0 of the action potential (MRD) of atrial and Purkinje fibres and prolongation of the atrial action potential duration (APD). Higher concentrations (40-100 microM) reduced MRD of papillary muscle without markedly affecting APD. Disopyramide (40-100 microM) reduced MRD and prolonged APD in similar concentrations in all three tissues. Reducing extracellular (EC) K+ to 2.8 mM decreased the effects of bepridil on MRD in all tissues but only significantly reduced the response to disopyramide in papillary muscle. Enhancement of APD prolongation by disopyramide in all tissues resulted when EC K+ was reduced, whereas only papillary muscle APD showed a marked prolongation in response to bepridil. These results demonstrate that the class I effect of bepridil is highly K+ dependent. It may be expected that QTc prolongation produced by both these drugs will be more marked in patients with low serum potassium levels.

On the effect of unstirred layers on K+-activated electrogenic Na+ pumping in cardiac Purkinje strands

Many studies of electrogenic Na+ pumping in Purkinje strands have involved intracellular Na+ loading by exposure to 0 mM K+, followed by reexposure to K+. For sheep Purkinje strands the K+ concentration for half-maximal stimulation (K0.5) in such studies is higher than K0.5 of canine Purkinje strands. A model was developed to determine if gradients in the K+ concentration of extracellular fluid layers during enhanced pump activity can account for the discrepancy. Pump activity was assumed linearly dependent on [Na+]i and dependent on [K+]o, according to Michaelis-Menten kinetics. The model simulated diffusion of K+ across unstirred layers and both depletion and accumulation of K+ in extracellular clefts of Purkinje strands during changes in the K+ concentration of the tissue bath. Errors in estimates of K0.5 occurred when delay in achieving a steady state extracellular K+ concentration was simulated. The simulations suggested that a linear relationship between pump current and intracellular Na+, a monoexponential decay of pump current, independence of the rate constants for the current decay on the initial Na+ load and holding potential, and apparent Michaelis-Menten K+ kinetics is not sufficient evidence against pump-induced interstitial K+ depletion having introduced errors in determination of K0.5. It is concluded that interstitial K+ depletion may account for the difference between determinations of K0.5 in sheep and canine Purkinje strands.

Characteristics of initiation and termination of catecholamine-induced triggered activity in atrial fibers of the coronary sinus

We studied epinephrine-induced delayed afterdepolarizations and triggered activity in atrial fibers from the canine coronary sinus to determine whether their responses to cardiac pacing would aid in formulating a uniform set of guidelines for differentiating this triggered activity from other arrhythmogenic mechanisms. We used standard microelectrode techniques and compared the delayed afterdepolarizations and triggered activity with those occurring in ouabain-superfused Purkinje fibers. Like Purkinje fibers, the frequency of triggering in the coronary sinus and the coupling interval of the first triggered beat were related directly to the basic drive cycle length, and the delayed afterdepolarization amplitude and frequency of triggering were related to the coupling interval of premature stimuli (S2). However, unlike Purkinje fibers, the coupling interval of the delayed afterdepolarization and of the first triggered beat were independent of the S2. Once initiated, triggered activity in the coronary sinus followed one of four rhythm patterns: in all four, the minimum and equilibrium cycle lengths were independent of the initiating cycle length. Triggered activity was terminated by overdrive and S2 pacing, especially by long episodes of overdrive at short cycle length. The first escape beat after overdrive was linearly related to the overdrive cycle length, resulting in overdrive acceleration. The return cycle length after S2 was linearly related to the S2 coupling interval. Because delayed afterdepolarizations and triggered activity in the coronary sinus respond differently to pacing from those in ouabain-superfused Purkinje fibers, triggered activity in general may not be identified by a uniform set of guidelines.

Effects of simultaneous administration of mexiletine and quinidine on the electrophysiologic parameters of canine Purkinje fibers

The electropharmacologic effects of an equimolar combination of mexiletine and quinidine on canine Purkinje action potential parameters were compared with the effects of either drug alone in concentrations ranging from 0.31 to 5.0 X 10(-5) M. Six separate experiments were performed with mexiletine alone, quinidine alone, and the combination. At low concentrations, all three shortened action potential duration (APD) and effective refractory period (ERP) to the same degree; however, the combination depressed Vmax to the same extent as did solutions containing twice the concentration of quinidine alone even though mexiletine alone, in these concentrations, had no effect on the maximum rate of depolarization of phase 0 of the action potential Vmax. In higher concentrations, the combination depressed Vmax and prolonged the ERP to values midway between that achieved by the two drugs separately. Although increasing concentrations of mexiletine alone progressively shortened APD, the combination prolonged this parameter to values similar to those seen with twice the concentration of quinidine alone. The electropharmacologic effects of mexiletine and quinidine in combination are not simply additive and cannot be entirely predicted on the basis of a knowledge of their effects in isolation.

6-Hydroxydopamine treatment enhances excitation of cultured cerebellar neurons by glutamate

Explant cultures containing identifiable cerebellar cortical neurons and locus coeruleus neurons were treated with 500 microM 6-hydroxydopamine. At this concentration, locus coeruleus neurons were usually degenerated after 48 h, while the cerebellar cortical neurons had a normal appearance. Extracellular recording and iontophoresis of noradrenaline and glutamate were used to test for changes in electrical activity or neurotransmitter responsiveness of the cerebellar neurons. At 4-5 days following the toxin exposure, spontaneous spiking activity appeared similar to that in control cultures. Mean iontophoretic currents required to give noradrenaline-induced depressions of activity were somewhat lower for the toxin-treated cultures than for controls but not significantly so. The mean currents for glutamate excitations, however, were markedly lower in the treated cultures. Noradrenaline potentiations of glutamate responses were observed in both treated and control cultures. The greatly increased sensitivity of cerebellar neurons to glutamate does not seem related to degeneration of granule cells in the treated cultures but might be explained by disruption of astrocytic uptake mechanisms for glutamate.

Rate-force relationship and calcium overload in canine Purkinje fibers

The relationship between driving rate and contractile force was studied in calcium-overloaded canine cardiac Purkinje fibers perfused in vitro. The following results were obtained. In Tyrode solution (2.7 mM Ca), increasing the drive rate ('overdrive') induced an initial decrease followed by a progressive increase in force; the initial decrease was more pronounced and the subsequent increase slower when the driving rate was faster; returning to the basal slow rate caused a transient increase in force above control and this increase was greater when overdrive was faster; a stepwise increase and decrease in rate led to an initial decrease in force with each increment in rate and an initial increase with each decrement in rate; increasing [Ca]o up to 16.2 mM reversed both the initial fall during and the transient increase in force after overdrive; these changes in force were associated with oscillatory potentials, a sign of calcium overload; similar results were obtained by inducing calcium overload with a low [Na]o solution or strophanthidin; the altered force patterns and the oscillatory potentials were reduced or eliminated if calcium load was reduced by decreasing the basal rate or [Ca]o, by increasing [K]o or by administering tetrodotoxin. It is concluded that in Purkinje fibers the force-frequency relationship is markedly altered in the presence of calcium overload because overdrive further increases the calcium load and this results in a reversal of the relation between calcium and force.

The effects of doxorubicin on ventricular tachycardia

Doxorubicin, in concentrations that have no effect on fast or slow response action potentials, has been shown to suppress ouabain-induced delayed afterdepolarizations. In this study, we used standard microelectrode techniques to determine the effects of doxorubicin on isolated canine Purkinje fibers. We studied automaticity induced at normal and low membrane potentials, conduction in normal and K+-depolarized Purkinje fibers, and triggered activity induced by ouabain and by experimental myocardial infarction. Doxorubicin, 50 microM, suppressed the triggered activity and the delayed afterdepolarizations that induced it, but had no effect on the other variables. We then studied the effects of intravenous doxorubicin, 16 to 64 mg/m2 body surface area, on ouabain-induced ventricular tachycardia and the ventricular tachycardia that occurs 24 hr after ligation of the left anterior descending coronary artery in the intact dog. There was no effect on the infarct-induced arrhythmia, but concentrations of doxorubicin that had no other effect on the electrocardiogram suppressed those ouabain-induced arrhythmias that appeared to have been triggered. The automatic arrhythmias induced by ouabain were not affected. Both the latter mechanisms were verified in studies of isolated Purkinje fibers that were obtained on completion of the intact animal experiments. These results indicate that agents having high selectivity for specific arrhythmogenic mechanisms can be useful adjuncts in discriminating among the mechanisms responsible for arrhythmias in intact animals.

Effects of tocainide on Purkinje fibers from normal and infarcted ventricular tissues

The left anterior descending coronary artery was occluded in anesthetized dogs. Dogs were sacrificed after 24 hours and the experimental preparations, which included both normal and infarcted tissues, were dissected from the left ventricles. Effects of tocainide in concentrations of 15-40 mg/l on action potentials of Purkinje fibers from normal and infarcted zones were studied using conventional microelectrode techniques. In the normal zone cells, tocainide superfusion produced a significant decrease in maximum diastolic potential, action potential amplitude, action potential duration to 50% and 90% repolarization and the rate of phase O depolarization, and no significant change in effective and functional refractory periods. In the infarct zone cells, it produced a significant decrease in action potential amplitude and the rate of phase O depolarization, a significant increase in effective and functional refractory periods, and no significant changes in the other parameters. The unequal actions of tocainide resulted in selective depression of maximum diastolic potential and action potential duration to 50% repolarization in the normal cells only, reducing the disparity in these parameters between normal and infarcted tissues. Tocainide increased the refractoriness (ratio of effective refractory period to action potential duration) in both cell types but this change was greater in the infarct zone. This decreased disparity of membrane potential and repolarization combined with increased refractoriness may help to block the arrhythmias observed in infarcted preparations following closely coupled stimuli.

Effect of norepinephrine and cyclic AMP on intracellular sodium ion activity and contractile force in canine cardiac Purkinje fibers

The effect of norepinephrine on the Na+-K+ pump was investigated by simultaneously measuring intracellular sodium ion activity (aiNa) and contractile force of canine cardiac Purkinje fibers driven at 1.0 Hz in K+-free solution, high K+ solution, and in the presence of tetrodotoxin. In Tyrode solution containing 5.4mM [K+]o, 10(-6) M norepinephrine decreased aiNa, whereas in K+-free solution 10(-6) M norepinephrine did not lower aiNa. 16.2 mM [K+]o decreased aiNa from 8.8 +/- 0.9 mM to 6.5 +/- 0.5 mM (mean +/- SD, n = 5). Exposure to 10(-6) M norepinephrine in the presence of high [K+]o further decreased aiNa by 0.7 +/- 0.4 mM. This further decrease was prevented by exposure to 2.5 X 10(-6) M strophanthidin (n = 4). Blockade of the fast sodium channel with 5 X 10(-6) M tetrodotoxin lowered aiNa from 8.5 +/- 1.3 mM to 7.4 +/- 1.1 mM (n = 4). Exposure to 10(-6) M norepinephrine in the presence of tetrodotoxin further lowered aiNa by 0.9 +/- 0.2 mM. We also studied the effects of the analogues of adenosine 3':5'-cyclic monophosphate, N6, 2'-0-dibutyryladenosine 3':5'-cyclic monophosphate, and 8-(4-chlorophenylthiol)-adenosine 3':5'-cyclic monophosphate on aiNa and twitch tension. Both analogues lowered to aiNa and increased twitch tension mimicking the effects of norepinephrine. Our results support the hypothesis that norepinephrine lowers aiNa by stimulating the Na+-K+ pump in this tissue. This stimulation appears to be mediated by adenosine 3':5'-cyclic monophosphate and does not appear to be due to intercellular K+ accumulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of delayed afterdepolarizations and triggered activity in canine Purkinje fibers by lysophosphoglycerides

Lysophosphoglycerides accumulate in ischemic myocardium and induce electrophysiologic alterations in normoxic tissue in vitro closely resembling those seen with ischemia in vivo. Delayed afterdepolarizations and triggered activity may be particularly important in the pathogenesis of arrhythmias in the ischemic heart. The present study was performed to determine whether lysophosphatidylcholine (LPC), at concentrations comparable to those present in ischemic myocardium, can induce delayed afterdepolarizations and/or triggered activity in normoxic canine Purkinje fibers. In the present study, as little as 75 microM LPC was found to induce delayed afterdepolarizations and as little as 100 microM LPC was found to induce delayed afterdepolarizations and triggered activity even at low cycle lengths. The amplitude of the induced delayed afterdepolarizations was enhanced by augmentation of the extracellular concentration of calcium (7 mM) or by exogenous epinephrine (10(-9) to 10(-6) M). The amplitude was decreased by verapamil (1 mg/l) or Mn++ (2.5 mM). Epinephrine at a concentration of 10(-6) M also initiated triggered activity in Purkinje fibers exposed to LPC (75 microM), a response blocked by l-propranolol (2 X 10(-7) M and 10(-6) M) but not by the alpha 1-adrenergic blocking agent BE-2254 (10(-6) M). Delayed afterdepolarizations induced by LPC (75 microM) and epinephrine (10(-6) M) persisted even in the presence of acidosis (pH 6.7) and hyperkalemia ([K+]o = 7 mM). Thus, delayed afterdepolarizations and triggered activity induced by LPC may contribute to the induction and/or maintenance of arrhythmias early after the onset of myocardial ischemia. However, because of the reversal of these effects after superfusion with media devoid of LPC, they may occur with ischemia in vivo but not be seen in tissue isolated from ischemic regions and evaluated in vitro.

The effect of chemical ablation of the endocardium on ventricular fibrillation threshold

The purpose of this study was to examine the effects of ablation of the superficial endocardium and Purkinje network on left ventricular fibrillation threshold. Lugol's solution was applied through small ventriculotomies to the left and right ventricular endocardium of 10 dogs on cardiopulmonary bypass. Two control groups of five animals each underwent either endocardial application of saline or epicardial application of Lugol's solution. Ventricular fibrillation threshold was measured before and after each intervention by the single-stimulus technique. Application of Lugol's solution to the endocardium resulted in a 102 +/- 15% increase in ventricular fibrillation threshold from a control value of 26 +/- 2 to 53 +/- 6 mA (p less than .005). In two animals, ventricular fibrillation could not be initiated postoperatively. In the control groups, there were no significant changes in ventricular fibrillation threshold. Histologic examination revealed that Lugol's solution obliterated less than 0.5 mm of superficial endocardium while sparing the adjacent myocardium. Electrophysiologic and rheologic data confirmed the discrete nature of the chemical injury. Thus ablation of the superficial ventricular endocardium with Lugol's solution results in a profound increase in the ventricular fibrillation threshold with only minimal tissue destruction.

Electrophysiological actions of N-(2,6-dimethylphenyl)-8-pyrrolizidine-acetamide hydrochloride hemihydrate (SUN 1165), a new antiarrhythmic agent

The electrophysiological actions of SUN 1165 on isolated guinea pig atrial and papillary muscles, canine Purkinje fibers, and rabbit sinoatrial node were studied using standard microelectrode techniques. SUN 1165 in low (10(-7) g/ml) concentration had little effect on any of the action potential parameters measured. Intermediate (10(-6) g/ml) concentration of the compound shortened the duration of action potential of canine Purkinje fibers and increased ratio of the effective refractory period to the duration of action potential at 90% repolarization in guinea pig atrial muscles. At high (10(-5) g/ml) concentration, the compound reduced the maximum rate of rise of phase 0 in guinea pig atrial, papillary muscles, and canine Purkinje fibers, though the change in the latter was not statistically significant, and also decreased the action potential amplitude in guinea pig atrial muscles and canine Purkinje fibers. At all concentrations (10(-7)-10(-5) g/ml) tested, the compound exerted little effect both on spontaneous action potentials in rabbit sinoatrial node cells and on Ca2+-mediated slow responses in partially depolarized guinea pig papillary muscles. These results indicate that SUN 1165 may selectively inhibit cardiac sodium channels and is likely to be of value in correcting not only ventricular but also supraventricular tachyarrhythmias.

On the mechanism underlying the oscillatory current in cardiac Purkinje fibers

The mechanism underlying the oscillatory current (Ios) was investigated in sheep cardiac Purkinje fibers with a voltage-clamp technique. The Ios is initiated not only by repolarizing but also by a depolarizing clamp, provided that the preparation is preloaded with calcium by means of a conditioning clamp and that the depolarizing test clamp initiates the slow inward current. The Ios initiated by a depolarizing test clamp is usually smaller and has a longer time to peak than that initiated by a repolarizing clamp to the same potential. Brief depolarizing clamps can be followed by an Ios in fibers preloaded with calcium. The amplitude of Ios diminishes as the interval from the conditioning clamp increases. No Ios is initiated by repolarizing or depolarizing clamps to potentials positive to approximately -30 to -40 mV even when [Na]0 is lowered. If a test clamp is applied at a peak of Ios to potentials less negative than approximately -30 mV, the current disappears. The membrane conductance during the Ios is lower. It is concluded that Ios is initiated indirectly by repolarization and is due to a calcium-triggered release of calcium which may initiate an electrogenic Na-Ca exchange.

Electrophysiologic effects of halothane and quinidine on canine Purkinje fibers: evidence for a synergistic interaction

The authors studied possible interactions between halothane and quinidine on the action potentials of canine Purkinje fibers superfused with Tyrode's solution. Using standard microelectrode techniques and a physiologic pacing rate (2 Hz), halothane in concentrations from 0.5% to 2% decreased the action potential duration to 50% repolarization (ADP50). Total ADP (APD100), in contrast, increased after 1% and 2% halothane. Resting membrane potential (RMP) and action potential amplitude (APamp) increased after 0.5% halothane, but returned to control with higher halothane levels. Conduction time (CT) increased at each halothane level. Pacing at faster (3 Hz) or slower (1 Hz) rates did not markedly alter the effects of halothane. Quinidine 1 X 10(-5)M decreased the phase O upstroke (Vmax) and prolonged APD100 and CT. When halothane was added, RMP and APamp decreased, Vmax decreased further, and APD100 and CT were markedly prolonged. This resulted in conduction block or inexcitability, especially at faster pacing rates (3 Hz). Synergistic interactions between halothane and quinidine were found on RMP, APamp, APD100, and CT. Effects on Vmax, APD50, and action potential duration to 90% repolarization (APD90) were additive. It is concluded that quinidine and halothane act synergistically to decrease action potential amplitude, lower RMP, and prolong conduction. Severe depression of conduction often progressed to conduction block or inexcitability when halothane, 2%, was administered during superfusion with therapeutic concentrations of quinidine.

Frequency-dependent actions of phenytoin in adult and young canine Purkinje fibers

Phenytoin has been reported to be particularly effective in the treatment of postoperative ventricular arrhythmias in children. The authors used standard microelectrode techniques to examine the developmental changes in the action of phenytoin on the transmembrane action potential of neonatal and adult canine Purkinje fibers. Their goals were to test whether developmental differences in phenytoin action on the action potential might explain the clinical observations and to evaluate the contribution of use-dependent reduction of Vmax and effects on slow responses to the antiarrhythmic action of phenytoin. In Tyrode's solution with [K+]0 = 4 mM, phenytoin at 5 and 10 micrograms/ml (concentrations comparable to therapeutic plasma levels) had no major effects on action potential characteristics or use dependence at either age. At [K+]0 = 6 mM, on decreasing the drive cycle length from 1300 to 300 msec, phenytoin reduced Vmax significantly and in a concentration-dependent manner. The magnitude of this action was similar at both ages. Conduction times were also significantly prolonged. The time constants for onset of (tau o) and recovery from (tau r) use-dependent block were similar in neonates and adults. The effects of phenytoin on slow responses were significant, although modest, at both ages, but there was no significant effect on conduction. This study indicates that in K+-depolarized Purkinje fibers, use-dependent reduction of the fast Na+ current is a major determinant of the antiarrhythmic action of phenytoin. In contrast to lidocaine and quinidine, no age-related changes in phenytoin action were found, underscoring the different developmental effects of individual antiarrhythmic drugs.

Voltage-dependent modulation of Ca channel current in heart cells by Bay K8644

We have investigated the voltage-dependent effects of the dihydropyridine Bay K8644 on Ca channel currents in calf Purkinje fibers and enzymatically dispersed rat ventricular myocytes. Bay K8644 increases the apparent rate of inactivation of these currents, measured during depolarizing voltage pulses, and shifts both channel activation and inactivation in the hyperpolarizing direction. Consequently, currents measured after hyperpolarizing conditioning pulses are larger in the presence of drug compared with control conditions, but are smaller than control if they are measured after positive conditioning pulses. Most of our experimental observations on macroscopic currents can be explained by a single drug-induced change in one rate constant of a simple kinetic model. The rate constant change is consistent with results obtained by others with single channel recordings.

In vitro evaluation of the beta-blocking and electrophysiological properties of mepindolol

The electrophysiological and beta-blocking effects of mepindolol have been examined in isolated guinea-pig preparations and sheep cardiac Purkinje fibers. Mepindolol did not show selectivity for blocking the chronotropic and inotropic responses to isoprenaline on isolated guinea-pig preparations, and was practically equally potent in blocking the effect of isoprenaline on isolated guinea-pig trachea. Mepindolol 10(-7) M fully antagonized the positive chronotropic effect of isoprenaline (10(-7) M) in Purkinje fibers. However, normal automaticity, action potential characteristics, effective refractory period, membrane responsiveness of Purkinje fibers were unaffected by mepindolol up to 10(-6) M. On the whole, mepindolol appears to be a potent beta-blocker with no cardioselectivity, exerting membrane depressant effect only at concentrations 100-1000 times higher than those exerting effective beta-blockade.