Document Detail

Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs.
MedLine Citation:
PMID:  9603538     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is increasing evidence that both functional reentrant wave fronts and multiple wavelets are present during ventricular fibrillation (VF). However, the effects of procainamide on the characteristics of activation waves during VF are poorly understood. METHODS AND RESULTS: Seven dogs were studied; six underwent subendocardial chemical ablation procedures. A plaque with 317 to 480 bipolar electrodes was sutured to the right ventricular free wall, and the patterns of activation were registered with a computerized mapping system. VF was electrically induced, and the patterns of activation were registered at baseline and during procainamide infusion (serum concentration, 9.3+/-1.9 microg/mL). Among the six dogs that had their subendocardium ablated, reentrant wave fronts were present in 6 of the 108 runs of VF at baseline and in 6 of the 100 runs of VF during procainamide infusion. By analyzing the wave fronts, we found that the cycle length, refractory period, conduction velocity, and wavelength at baseline were 101+/-9 ms, 54+/-5 ms, 0.93+/-0.21 mm/ms, and 51+/-16 mm, respectively, and during procainamide infusion, values became 125+/-11 ms (P<.001), 119+/-7 ms (P<.001), 0.42+/-0.02 mm/ms (P<.001), and 50+/-4 mm (P=.8), respectively. The vast majority of the activation waves do not form organized reentry. These activation waves broke up more frequently at baseline than during procainamide administration. The number of activation waves was 7.25+/-1.39 s(-1) x cm(-2) at baseline and 4.45+/-1.80 s(-1) x cm(-2) during procainamide administration (P<.001). The dog without subendocardial ablation had similar results. CONCLUSIONS: Procainamide decreases the number of wavelets during VF by preventing spontaneous wave breaks. This represents a novel mechanism of antiarrhythmic drug action.
Y Y Kwan; W Fan; D Hough; J J Lee; M C Fishbein; H S Karagueuzian; P S Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  97     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-06-11     Completed Date:  1998-06-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1828-36     Citation Subset:  AIM; IM    
Department of Medicine, Cedars-Sinai Medical Center and University of California, Los Angeles, School of Medicine, 90048, USA.
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MeSH Terms
Anti-Arrhythmia Agents / pharmacology*,  therapeutic use
Cardiac Pacing, Artificial
Electric Countershock
Heart Conduction System / drug effects*
Heart Ventricles / physiopathology
Myocardium / pathology
Procainamide / pharmacology*,  therapeutic use
Ventricular Fibrillation / drug therapy,  physiopathology*,  therapy
Grant Support
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 51-06-9/Procainamide
Comment In:
Circulation. 1999 Apr 27;99(16):2220-1   [PMID:  10217701 ]

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