To explore ionic mechanisms of the positive inotropic process in guinea pig ventricular papillary muscles, we simultaneously measured twitch tension, intracellular Na+ activity (aiNa) and action potential at a stimulus rate of 60/min. The aiNa was 5.0 +/- 0.1 mM in the steady state. When the Na-K pump was inhibited by ouabain (1 microM), the twitch tension was increased in proportion to the aiNa, and the action potential was decreased at diastolic state and at duration for 90% of repolarization (APD90). While exposed to caffeine (3 mM), the aiNa kept increasing even when the twitch tension achieved a peak level. Concomitantly, the action potential slightly depolarized at diastolic state with a prolonged APD90. An application of DBcAMP (1 mM) or an increase in [Ca2+]o (from 1.8 to 3.6 mM) enhanced the twitch tension with a fall of aiNa and a shortening of APD90. These results suggest that in guinea pig papillary muscles Na-Ca exchange plays an important role in the regulation of contractile force and membrane potential, and that the Na influx should be balanced by the activation of the sarcolemmal Na-K pump, a negative feedback mechanism, to prevent calcium overload and abnormal pacemaker activity in electrical excitation.