ABSTRACT. The parasympathetic nervous system attenuates the effects of sympathetic interventions on the hearts of mature animals. Whereas the vagal mediator, acetylchoIine (ACh}, alone has minor effects on electrophysiologic properties of the ventricular conducting system, in the presence of sympathetic amines, it induces an accentuated antagonism. Because there are developmental changes in both sympathetic and parasympathetic effects on the heart we studied the parasympathetic and sympathetic interaction in isolated neonatal canine Purkinje fibers (PF), and compared the results to those in adult PF. PF were exposed to isoproterenol (Iso) alone (1 x 10-9 , 1 x 10-7 and 1 x 10-s M) to ACh alone (1 x 10-7 or 1 x 10-s M) and to Iso in the presence of ACh. In adult PF, superfusion with Iso, 10-s M, alone shortened action potential duration to 50% repolarization from a control value of 215 ± 9 to 200 ± 9 ms (p < 0.01). Simultaneous superfusion of adult PF with Iso 10-s M and Ach 10-s M decreased the extent of action potential shortening produced by Iso, so that action potential duration to 50 % repolarization shortened from a control value of 221 ± 8 to only 214 ± 12 ms (p < 0.01). The response to superfusion with Iso and Ach (lo-s M) differed significantly from that with Iso alone (p < 0.01). In contrast, exposure of neonatal PF to Iso (10-s M) prolonged action potential duration to 50 % repolarization from a control value of 157 ± 7 to 180 ± 5 ms (p < 0.01). No inhibition of the effect of Iso by Ach (10-7 or 10-s M) was observed in neonatal PF. At neither age did ACh, alone exert a significant effect. Our data suggest that accentuated ~ntagonism is not _present in young animals having an immature autonomic nervous system, but that it occurs subsequent to maturation. (Pediatr Res 20: 613-618, 1986) The interactions of the sympathetic and parasympathetic nervous systems have l~mg been an area of interest. For example, Rosenblueth and Simone (I) found that the absolute reduction in heart rate produced by a vagal stimulus in anesthetized cats was greater when the basal heart rate previously had been incre~sed by sympathetic stimulation. Further study of this interaction_ has le? to the concept of accentuated antagonism (2, 3); 1.e. stimulation of parasympathetic efferent nerves has little depressant effect on heart rate or contractility; but the greater !he background level of sympathetic activity, the more profound 1s the depressant effect of a given vagal stimulus ( 4-7). The net result of the inhibitory effect of cholinergic activation is not simpl)'. an algebraic sum of _the respective activities of the sympathe!ic and parasympathetic nervous systems; but is greater in magnitude as sympathetic activation is increased (2, 8, 9).There were two reasons for performing the present study. First alth~:mg~ Ach _inhibits the electrophysiologic effects of sympa~ thetic stimulation of adult canine PF (I 0-12), and the effects of cholinergic input depend on the prevailing level of sympathetic activity (2, 8, 9), we are not...