Effect of Digitalis in Patients Receiving Reserpine

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Abstract
Rauwolfia derivatives sensitize the heart to the potentially toxic action of digitalis. The interaction between the two drugs was studied by acutely digitalizing patients in chronic congestive heart failure with the ultra rapid agent acetyl strophanthidin immediately before and during the administration of reserpine. A potentiation of digitalis action upon the atria, atrio ventricular conduction system and ventricles was demonstrated only in patients with atrial fibrillation. While 8 out of 9 patients in atrial fibrillation who were receiving reserpine developed advanced toxic rhythms during acute digitalization, only one patient responded in this fashion when reserpine was not given. Patients receiving reserpine were unable to tolerate full doses of acetyl strophanthidin. Reserpine increased cardiac sensitivity to carotid sinus stimulation. This was true irrespective of heart rhythm, and was most marked when the patient received digitalis as well. Reserpine did not prevent significant acceleration in the ventricular rate following exercise.