Effect of the opiate antagonist naloxone on digitalis induced cardiac arrhythmias

To test the hypothesis that the endogenous opioid system is operative in digitalis arrhythmias, guinea pigs anesthetized with pentothal and breathing spontaneously were allocated to a control group or four naloxone groups: 0.1 mg/kg i.v., 1.0 mg/kg i.v., 2 mg/kg i.v. or 4 mg/kg i.v. after the induction of arrhythmias by digoxin 100 micrograms/kg i.v. every 15 min. Naloxone at higher doses resulted in a rapid development of fatal arrhythmias with high degree AV block being more frequent than ventricular tachycardiac or fibrillation. Survival was significantly and inversely related to naloxone dose. The role of the autonomic nervous system was studied using cervical cord transection at the C7 level or bilateral cervical vagotomy, or atropine 1.2 mg/kg pretreatment. Cord transection, but not vagotomy, was associated with a significantly higher digoxin dose to produce arrhythmias. Naloxone 4 mg/kg i.v. shortened survival in cord transected animals, but less than in intact animals. Naloxone did not alter survival in vagotomized animals or animals that were pretreated with atropine. Thus, naloxone accelerates the development of fatal cardiac arrhythmias suggesting that endogenous opioids are involved in digitalis toxic arrhythmias an effect interrelated to the autonomic, mainly parasympathetic, nervous system.