Comparison of the direct effects of nifedipine and verapamil on the electrical activity of the sinoatrial and atrioventricular nodes of the rabbit heart.

We compared the effects of nifedipine and verapamil on the rabbit sinus and atrioventricular nodes. Both drugs slowed the rate of impulse initiation by sinus node cells. Verapamil exerted a greater negative chronotropic effect at low concentrations, but at higher concentrations verapamil and nifedipine were equipotent. Nifedipine also reduced the amplitude of sinus node action potentials and the Vmax of phase O, effects which are identical to those previously described for verapamil. Both drugs slowed AV nodal conduction and prolonged refractory periods, but verapamil was more potent than nifedipine. Nifedipine reduced the amplitude of AV nodal action potentials and Vmax of phase O the same as verapamil. Nifedipine and verapamil, therefore, have nearly identical direct effects on the nodes. The failure of nifedipine to depress AV nodal conduction in situ and abolish reentrant AV nodal tachycardia is probably a result of the decreased sensitivity of the AV node to nifedipine compared to verapamil.