Effects of verapamil on ventricular tachycardia induced by ouabain in guinea pigs.

Calcium ions appear to play a central role in the development of ventricular arrhythmias associated with digitalis intoxication. Therefore, the effects of the calcium channel antagonist, verapamil, on ouabain-induced ventricular tachycardia were investigated. Ventricular tachycardia (three or more consecutive wide QRS complexes) was induced in guinea pigs by intravenous infusion of ouabain (1 microgram/min) and bursts of rapid ventricular stimulation. Of seven guinea pigs given the infusion of ouabain, all developed ventricular tachycardia at a dose of 82 +/- 17 micrograms/kg (mean +/- SD) and none developed heart block or asystole. Eight guinea pigs were treated with verapamil (2 micrograms/min for 30 minutes) prior to exposure to ouabain. Of those eight animals, only two developed ventricular tachycardia but six developed heart block or asystole at a significantly higher dose of ouabain (154 +/- 47 micrograms/kg). None of three control guinea pigs given an infusion of normal saline for 90 minutes developed ventricular tachycardia. These results show that pretreatment with verapamil inhibits ouabain-induced ventricular tachycardia in guinea pigs. Combined treatment with verapamil and ouabain is associated with a high incidence of heart block and asystole, which may limit the usefulness of verapamil.