Effects of calcium blockers on ventricular fibrillation during acute myocardial infarction

1. The effects of the calcium blockers bepridil and verapamil on latency time to ventricular fibrillation (VF) and VF incidence were assessed in 109 anesthetized dogs, submitted to coronary occlusion and reperfusion. 2. In 19 dogs (Group I) submitted to global left ventricular ischemia, both bepridil and verapamil significantly (P less than 0.05) prolonged latency time as compared to 14 untreated controls. However, VF was not prevented by any of these drugs. Both drugs were given 15 min before coronary ligation. 3. In 76 dogs (Group II) submitted to regional myocardial ischemia (left anterior descending coronary artery (LAD) occlusion for 2 hours followed by 30 min reperfusion), VF incidence during occlusion was significantly reduced by verapamil as compared to controls (0/21 vs 10/25; P less than 0.05) but not by bepridil (10/25 vs 12/30; P = ns). During reperfusion, however, neither drug affected fibrillation incidence or latency time. 4. No correlation was observed between anti-arrhythmic drug effects and infarct size as measured by triphenyl tetrazolium chloride. 5. We conclude that both bepridil and verapamil significantly delayed the occurrence of fibrillation in acute ischemia due to coronary ligation. However, only verapamil prevented fibrillation and this effect was restricted to the occlusion phase. In contrast, during reperfusion, neither drug prevented fibrillation. Thus, VF during occlusion and reperfusion is likely to be mediated by different mechanisms.