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Related Experiment Videos

Cocaine-induced supersensitivity and arrhythmogenesis.

H Inoue1, D P Zipes

  • 1Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis 46202.

Journal of the American College of Cardiology
|April 1, 1988
PubMed
Summary

Cocaine amplifies norepinephrine

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Area of Science:

  • Cardiovascular Pharmacology
  • Autonomic Nervous System
  • Cardiac Electrophysiology

Background:

  • The exact cause of sudden death associated with cocaine use remains unclear.
  • Cocaine's impact on cardiac function, particularly in conjunction with sympathetic nervous system activation, requires further investigation.

Purpose of the Study:

  • To investigate whether cocaine potentiates cardiac electrophysiological changes induced by norepinephrine and sympathetic stimulation.
  • To determine the effect of cocaine on sinus cycle length, atrioventricular nodal conduction (AH interval), and ventricular effective refractory period.

Main Methods:

  • Dose-response curves for norepinephrine infusion and frequency-response curves for ansae subclaviae stimulation were established in anesthetized dogs.
  • These electrophysiological parameters were measured before and after intravenous cocaine administration.
  • Ventricular tachyarrhythmias were assessed in dogs with and without acute myocardial infarction.

Main Results:

  • Cocaine potentiated norepinephrine-induced shortening of sinus cycle length, AH interval, and ventricular effective refractory period, indicating supersensitivity in some dogs.
  • Cocaine enhanced the effect of sympathetic stimulation on ventricular effective refractory period in dogs without supersensitivity.
  • Cocaine significantly increased the incidence of ventricular tachycardia in dogs with acute myocardial infarction when combined with norepinephrine.

Conclusions:

  • Cocaine can potentiate sympathetic nervous system effects on cardiac electrophysiology.
  • The combination of cocaine and sympathetic activation, especially during myocardial infarction, may increase the risk of life-threatening arrhythmias.

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