Electrophysiological effects of amrinone and milrinone in an isolated canine cardiac tissue model of ischemia and reperfusion.

The purpose of this study was to determine if amrinone or milrinone after the electrophysiological responses of canine ventricular tissues to "ischemia" or reperfusion. Isolated canine Purkinje tissue-papillary muscle preparations were studied using standard microelectrode techniques. Tissues were superfused for 10 min with a solution that mimicked ischemia (hypoxia, acidosis, elevated lactate levels and zero substrate). Reperfusion with normal Tyrode's solution was then instituted for 60 min. Next, tissues were equilibrated with amrinone (5.3 X 10(-4) M) or milrinone (2.5 X 10(-4) M) for 15 min and the protocol was repeated with drug in all solutions. Without drug, ischemic conditions resulted in moderate depolarization of Purkinje and muscle tissues. Reperfusion caused a rapid hyperpolarization in Purkinje tissue. This was followed by a phase of mild depolarization associated with enhanced pacemaker activity. All preparations recovered by 45 min of reperfusion. With amrinone or milrinone present, the changes in membrane potential induced by conditions of ischemia and reperfusion were not different from control. However, an early phase of very rapid ectopic activity was seen during reperfusion with amrinone or milrinone. This ectopic activity had a constant cycle length during the pauses in stimulation. However, irregular patterns of spontaneous and driven beats were observed when electrical stimulation was superimposed on the ectopic activity. Amrinone and milrinone also increased pacemaker activity in Purkinje tissue but this occurred later in reperfusion. This study demonstrates that amrinone and milrinone sensitize isolated canine ventricular tissues to the arrhythmogenic effects of reperfusion. The mechanism underlying the arrhythmic activity elicited by the bipyridines is not clear, but may involve re-entry or abnormal automaticity.