Reduced tolerance to digitalis-induced arrhythmias caused by coronary-flow alterations in isolated perfused heart of guinea pigs.

The ligation of a main branch of coronary vein elevates the sensitivity of isolated, perfused (Langendorff) preparations of guinea-pig heart to arrhythmogenic actions of digoxin. Retrograde perfusion studies indicate that the presence of an area with a high extracellular K+ concentration, adjacent to an area with normal K+ concentration and exposed to the glycoside, predisposes the heart to digitalis-induced toxicity. This model may be useful in studying the mechanism by which acute myocardial infarction decreases the therapeutic index of cardiac glycosides.