Anapylactic events occurring in cardiac tissue can result in severe metabolic imbalances. The present study addresses the question of whether adenosine, produced in response to this stress, influences either the antigen-antibody-induced alterations in cardiac function or the release of histamine, which is known to be one of the important mediators of the anaphylactic reaction. Isolated hearts of passively sensitized guinea pigs were perfused at constqant flow in a Langendorff preparation with physiological salt solution. Under control conditions, antigen challenge evoked a rapid transient release of histamine, an increase in coronary vascular resistance and beating rate, and an increase followed by a decrease in left ventricular systolic pressure. The antigen-induced transient increase in adenosine release from 0.26±0.07 to 4.66±0.48 nmol/min/g was associated with a 75±9% increase in the PR interval in all hearts and atrioventricular blocks in six of 17 hearts. Antigen challenge was also conducted in the presence of theophylline, 8-(4-sulfophenyl) theophylline (SP-T), erythro-9-(2-hydroxy-3-nonyl) adenosine hydrochloride (EHNA), or exogenous adenosine. The major findings were that 1) the antigen-induced prolongation of the PR interval was attenuated by the adenosine receptor blockers theophylline (to 23±6%) and SP-T (to 15±4%); 2) the incidence of antigen-induced atrioventricular blocks tended to be decreased by theophylline (to three of 10 hearts) and SP-T (to zero of seven hearts) and to be increased by the adenosine deaminase inhibitor, EHNA (to six of 10 hearts); 3) none of the interventions had major influences upon antigen-induced upon antigen-induced alterations in vascular resistance, atrial automaticity, or systolic pressure; and 4) EHNA and adenosine both significantly increased adenosine levels before anaphylaxis and also enhanced the total histamine release induced by antigen challenge from a control value of 2,321±244 ng/g to 3,424±307 ng/g and 4,298±616 ng/g, respectively. We conclude from our data that increases in levels of endogenous adenosine during cardiac anaphylaxis may contribute to the development of atrioventricular conduction delays and blocks and that increases in levels of adenosine before antigen challenge may increase the amount of histamine released during cardiac anapylactic reactions.