Bretylium increases myocardial contractility via catecholamine release but subsequently blocks nerve-mediated catecholamine release.
Bretylium's dual adrenergic effects in animals remain untested in humans; leaves open net impact on clinical sympathetic modulation.
The increased myocardial contractility resulting from the injection of bretylium has been shown to be accompanied by a myocardial release of catecholamines. Cardiac sympathetic nerve stimulation following bretylium is associated with neither an increased contractility nor a release of myocardial catecholamines. The failure to release catecholamines under these conditions does not result from depletion, but rather from a block of the nerve release mechanism.
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Gilmore et al. (1962) studied this question.