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Effect of nitroglycerin on ventricular fibrillation threshold of nonischemic myocardium
Authors:Neil Dashkoff  J-Michel A. Roland  P.Jacob Varghese  Bertram Pitt
Affiliation:1. From the Departments of Medicine and Pediatrics, Cardiovascular Division, The Johns Hopkins University, Baltimore, Md. U.S.A.;2. From the Departments of Medicine and Pediatrics, Cardiovascular Division, Johns Hopkins Hospital, Baltimore, Md. U.S.A.
Abstract:The threshold for ventricular fibrillation induced by a 200 msec train of pulses was measured during a control period and during an intravenous infusion of nitroglycerin in 14 nonischemic open chest dogs. Infusion of nitroglycerin in doses sufficient to reduce mean arterial blood pressure an average of 17 mm Hg was associated with a rise in ventricular fibrillation threshold from a control value of 24 ± 3 (mean ± 1 standard error of the mean) to 41 ± 6 milliamperes (P < 0.001). In a subgroup of six animals simultaneous infusions of nitroglycerin and phenylephrine abolished the hypotensive effect of nitroglycerin but did not significantly alter the rise in ventricular fibrillation threshold observed with nitroglycerin infusion alone. In five other animals mean arterial blood pressure was similarly reduced an average of 17 mm Hg by venous hemorrhage, but was associated with a lowering rather than a rise in ventricular fibrillation threshold from a prehemorrhage value of 28 ± 6 to 15 ± 2 milliamperes, (P < 0.005). Thus, intravenously administered nitroglycerin raises ventricular fibrillation threshold in nonischemic canine myocardium independent of its hypotensive effects.
Keywords:Address for reprints: Bertram Pitt   MD   Department of Medicine   Cardiovascular Division   The Johns Hopkins Hospital   Baltimore   Md. 21205.
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