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Cocaine‐induced ventricular fibrillation: protection afforded by the calcium antagonist verapamil
Author(s) -
Billman George E.,
Hoskins Richard S.
Publication year - 1988
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2.14.3181653
Subject(s) - verapamil , ventricular fibrillation , medicine , cardiology , heart rate , anesthesia , antagonist , ischemia , calcium channel , calcium channel blocker , hemodynamics , calcium , blood pressure , receptor
There is increasing evidence that the use of cocaine can trigger lethal cardiac events, including ventricular fibrillation. The mechanism responsible for these lethal cardiac arrhythmias remains to be determined. Therefore, 13 mongrel dogs were instrumented so that heart rate, left ventricular pressure (LVP), and d(LVP)/dt could be measured. After a 3‐ to 4‐wk recovery period, the left circumflex coronary artery was occluded for 2 min, beginning with the last minute of an exercise stress test and continuing for 1 min after the cessation of exercise. None of the dogs developed cardiac arrhythmias during the control exercise plus ischemia test. On a subsequent day, the test was. repeated after the injection of cocaine HCl (1.0 mg/kg). Cocaine significantly ( P < 0.01) elevated heart rate, systolic LVP, and d(LVP)/dt, and it elicited cardiac arrhythmias in 12 of the 13 animals during the exercise plus test. In fact, 11 animals developed ventricular fibrillation. Verapamil, a calcium channel antagonist (250 μg/kg), attenuated the hemodynamic effects of cocaine and prevented the development of ventricular arrhythmias. These data suggest that cocaine can induce ventricular fibrillation during myocardial ischemia and that these lethal arrhythmias may be prevented by a calcium channel antagonist.— B illman , G. E.; H oskins , R. S. Cocaine‐induced ventricular fibrillation: protection afforded by the calcium antagonist verapamil. FASEB J. 2: 2990‐2995; 1988.