With pronethalol, quinidine, and reserpine it was necessary to increase the dose of acetylstrophanthidin which produced arrhythmia in combination with vagal stimulation. However, in reserpine-treated animals, quinidine and pronethalol were ineffective. The capability of large doses of acetylstrophanthidin to produce ventricular arrhythmia was not diminished by quinidine, pronethalol, or reserpine. While pronethalol decreased the S-A nodal rate in normal animals, it failed to produce an effect on rate after reserpine pretreatment. Since after catecholamine depletion by reserpine, pronethalol and quinidine did not affect acetylstrophanthidin-induced ventricular arrhythmia, it is suggested that the antidigitalis effect of these agents is related to their actions to diminish adrenergic nervous activity.
ADDITIONAL KEY WORDS digitalis toxicityantiarrhythmic agents antiadrenergic agents adrenergic innervation beta receptor blockade• A relationship between adrenergic nervous activity and digitalis-induced ventricular arrhythmia has been suggested in previous reports.1 ' 2 Roberts et al. 1 demonstrated that ventricular arrhythmias produced by small doses of acetylstrophanthidin could be prevented by treatment with reserpine, whereas those produced by large doses were not affected. Erlij and Mendez 2 reported that reserpine as well as sympathectomy and adrenalectomy caused an increase in the dose of digitoxin necessary to produce death. Pronethalol, which blocks the effects of catecholamines on the heart,"' 4 has also been reported Accepted for publication June 20, 1966. to block the arrhythmia induced by digitalis materials.5 " 7 However, since none of the studies with pronethalol were performed in hearts depleted of catecholamines, it was not clear whether its effect on the "digitalis arrhythmia" was related to blockade of adrenergic activity. If the action of pronethalol was dependent on its antiadrenergic properties, it should have a diminished antidigitalis effect in reserpine-treated animals.Quinidine has also been reported to block arrhythmias induced by small doses of acetylstrophanthidin. 8 Moreover, quinidine is known to antagonize the cardiac effects of exogenous catecholamines 9 " 11 and therefore it is possible that the antidigitalis properties of quinidine are related, at least in part, to blockade of adrenergic activity.This investigation was undertaken to explore the influence of quinidine and pronethalol on the capability of acetylstrophanthidin to produce ventricular arrhythmia in normal and reserpine-treated cats. The results of this study indicate that neither pronethalol nor quinidine exert an antidigitaUs action in hearts treated with reserpine.
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