CHEMICAL FACTORS IN VENTRICULAR FIBRILLATION

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Abstract
The 18 experiments on which this paper is based were performed (9 on dogs and 9 on the isolated perfused heart) to test the theory that the electric stimulus or other factor producing ventricular fibrillation may do so by means of atomic disturbance of some protein-salt molecule, thus surrounding the muscle fibers, with an abnormal chemical medium which changes their action. The experimental production of ventricular fibrillation by chemical additions to the circulating fluid would support this view. NaHCO3, irrespective of its buffer action, exerts an influence on the perfused dog heart such that a lighter stimulus is required to throw it into fibrillation; it may also induce spontaneous fibrillation if present in a perfusate which is suddenly substituted for a perfusate similar but without bicarbonate. If used in conjunction with KCl and CaCl2 in efforts to resuscitate a fibrillating heart, in situ it lessens the chance of a successful recovery. CaCl2, similarly, influences the dog heart with respect to fibrillation. If present in 2 perfusates prepared for the isolated heart in amounts of 0.023% and 0.15% sudden transition from the weaker to the stronger solution will usually throw the ventricles into fibrillation. The presence of CaCl2 stronger than 0.023% in the solution used in efforts to resuscitate a fibrillating heart in situ, likewise lessens the chance of recovery.

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