Abstract

After recovery from acetylstrophanthidin-induced ventricular tachycardia, a repetitive ventricular response (RVR) following a single diastolic stimulus could be elicited for 22 minutes. With atrial pacing at the maximum ventricular follow rate, RVR was obtainable for 70 minutes. A pause in pacing also evoked a ventricular ectopic beat; however, this persisted for only 27 minutes. The minimum heart rate required for RVR was always less than the minimum rate required for pause-induced ectopic beats. Extrasystoles following a pause during pacing, RVR in sinus rhythm, and RVR during rapid heart rates represent decreasing levels of ventricular automaticity corresponding to progressive dissipation of digitalis intoxication. The underlying mechanism for RVR probably is due to net loss of intracellular potassium, which can be induced both by digitalization and by rate acceleration.

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