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November 24, 1956


JAMA. 1956;162(13):1256. doi:10.1001/jama.1956.02970300056022

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To the Editor:—  The occurrence of premature ventricular contractions due to Rauwolfia serpentina therapy has been recorded. Wilson and Wimberly (J. A. M. A.159:1363 [Dec. 3] 1955) reported four cases in which this phenomenon was observed. One of the patients under observation by the above authors was on digitalis therapy. This fact elicited discussion among us and prompted this investigation. Wilson and Wimberly regarded the etiology or the mechanism of production of the premature beats as problematical, but speculated that "the bradycardia may allow a so-called irritable focus in the ventricle to become manifest." One of us ( C. J. S. ) had the opinion that, if this were true, the phenomenon would be more manifest in patients on digitalis therapy, because of the altered myocardial irritability in such patients. Digitalis, although it exerts a depressant action on myocardial irritability, may increase the irritability of a focus and thus initiate

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