Effects of calcium antagonists on the alternation of the ST-T complex and associated conduction abnormalities during coronary occlusion in dogs.

1 The effects of Ca2+ -antagonists on the relationships between alternate changes in the ST-T complex in the epicardial electrogram, ST-T alternans, and associated excitation-conduction abnormalities during coronary occlusion were examined in anaesthetized dogs. 2 Epicardial unipolar electrograms, bipolar electrograms (BPEG) and monophasic action potentials (MAP) were recorded with unipolar, composite and suction electrodes, respectively. 3 ST-T alternans was associated with serious conduction delay. During the period of ST-T alternans, the amplitude of MAP changed alternately and the negative deflection of the ST-T complex was associated with a larger MAP. A depression of the TQ level and decrease in the resting potential of MAP were marked. 4 Verapamil (0.2 mg/kg) and diltiazem (0.5 mg/kg) inhibited ST-T alternans, conduction abnormalities, TQ depression and changes in MAP. However, after these drugs, the TQ depression and the decrease in the resting potential were evident after a longer period of occlusion at a time when ST-T alternans, conduction abnormalities and alternate changes in MAP were still inhibited. Dipyridamole (0.5 mg/kg) had no effect on either ST-T alternans or the conduction abnormalities. 5 Verapamil and diltiazem inhibited ST-T alternans and the associated excitation and conduction abnormalities. The effects of these two drugs cannot be explained on the basis of attenuation of the decrease in the resting potential.