Drug-Induced Pulsus Alternans in Dogs.

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Abstract
Experimental pulsus alternans and pseudoalternans were produced in pentobarbitalized dogs by intravenous injection of one of several sympathomimetic amines. Epinephrine, ephedrine, neosynephrine, methamphetamine and occasionally methoxamine resulted in bigeminal rhythm in which premature ventricular contractions alternated with pulses of sinus origin (pseudoalternans). Methoxamine hydrochloride more often resulted in "true" pulsus alternans with no ecg differences between the alternating weaker and stronger beats. Pulsus alternans induced by the above compounds was reversible. Onset occurred about 1 minute after injection; duration was usually in excess of 5 minutes. Although onset was usually gradual, occasionally it was sudden, the consequence of a single premature ventricular contraction. Pulsus alternans frequently progressed in severity to absence of the arterial pulse (pulse deficit) when, during the weaker beat, intraventricular pressure failed to reach arterial diastolic pressure. This emphasizes a need for recording more than one parameter when assessing drug-induced cardiovascular changes.

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