Research Article| Volume 76, ISSUE 2, P240-256, August 1970

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Selective stimulation, suppression, or blockade of the atrioventricular node and His bundle

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      In 52 dogs anesthetized with sodium pentobarbital, the septal artery and the atrioventricular (A-V) node artery were cannulated for direct perfusion of the His bundle and A-V node. Advantages of this method include preservation of the heart in situ with its normal innervation intact and the production of localized effects by injection of small (2 ml.) amounts of test substances. One disadvantage is the unavoidable simultaneous perfusion of ventricular myocardium. Utilizing this method, we produced transient A-V block with acetylcholine, 0.1 to 1.0 μg per milliliter, and prolonged block with neostigmine, 10 μg per milliliter; this effect is reversed and blocked with local administration of atropine, 10 μg per milliliter. Direct perfusion of the septal artery or the A-V-node artery with norepinephrine or isoproterenol, 0.1 μg per milliliter, produced an A-V junctional tachycardia which could be blocked with propranolol, 10 μg per milliliter; more prolonged tachycardia was produced with tyramine, 10 μg per milliliter, or guanethidine, 100 μg per milliliter, and could be transiently reversed with acetylcholine, which also caused transient simultaneous A-V block. These experiments demonstrate the specific production and precise control of transient or prolonged A-V block or junctional tachycardia in the intact heart in situ.
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