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The effects of synchronized direct current countershock on ventricular automaticity, intraventricular conduction, and atrioventricular conduction were studied before and after ouabain administration and after diphenylhydantoin. At the level of electrical energy that induced ventricular arrhythmias, averaging 159 watt-seconds, countershock transiently increased ventricular automaticity and prolonged both intraventricular and atrioventricular conduction time. Immediately after ouabain-induced ventricular tachycardia returned to regular sinus rhythm, underlying ventricular automaticity and intraventricular and atrioventricular conduction times were increased. An average of 23 watt-seconds produced overt and persistent ventricular tachycardias due to enhanced automaticity or re-entry. Atrioventricular and intraventricular conduction times were also prolonged, and transient complete heart block occurred in two experiments. Diphenylhydantoin administration at this time depressed ventricular automaticity, caused a speeding of atrioventricular and intraventricular conduction times and increased the electrical energy necessary to produce ventricular tachycardia to 355 watt-seconds.

circulation research

Electrophysiological Effects of Direct Current Countershock before and after Ouabain Sensitization and after Diphenylhydantoin Desensitization in the Dog