CHIBA S. Pharmacologic basis of responses to midazolamin the isolated, cross-perfused, canine right atrium. 1987;66:711-8.The effects of midazolam on atrial rate and contractileforce in the isolated canine atrium perfused with donor blood were investigated. When midazolam in a dose range of 100-1000 pg was injected directly into the sinus node artery of the isolated atrium, biphasic (negative followed by positive) chronotropic and triphusic (positive, negative followed by positive) inotropic effects were induced. After propranolol or imipramine, the positive chronotropic and the ~econdary positive inotropic effects were significantly suppressed, but the initial positive inotropic effect was not affected. Tetrodotoxin, atropine, or R05-4864, a selective ligand for peripheral benzodiazepine binding sites, did not modify midazolam-induced effects. When midatolam in a dose of0.1-2 mglkg was administered intravenously to the donor dog, monophasic negative chronotropic and inotropic effects in the isolated atrium wereobserved but were not as prominent. We conclude that midazolam has direct cardiac inhibitory properties including catecholamine release due to a tyramine-like action.