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Effects of antagonists on the ST alternans during acute coronary occlusion were examined in dogs. The intravenous administration of verapamil at doses of 0.1 mg/Kg and 0.2 mg/Kg prominently attenuated the degree of alternans. Diltiazem at dose of 0.2 mg/Kg also attenuated the degree of alternans. Dipyridamole at dose of 0.5 mg/Kg did not significantly attenuate the degree of alternans. Verapamil significantly inhibited the ST-segment elevation. After verapamil, ST alternans did not occur even after a longer period of occlusion when changes in QRS complex and the ST-segment elevation were remarkable. It is possible that verapamil inhibits ST alternans by both the protecting effect against ischemic injury and a direct effect on the electrical activity of the myocardial cell membrane.

Effect of calcium antagonists on the electrical alternans of the ST segment during acute coronary occlusion in dogs.