Document Detail

Electrophysiologic properties and antiarrhythmic mechanisms of intravenous N-acetylprocainamide in patients with ventricular dysrhythmias.
MedLine Citation:
PMID:  6189384     Owner:  NLM     Status:  MEDLINE    
To define electrophysiologic properties and antiarrhythmic mechanisms of N-acetylprocainamide (NAPA), we studied 16 patients with symptomatic ventricular dysrhythmias. Electrophysiologic studies were performed before and after intravenous infusion of NAPA at 20 mg/kg over 20 minutes, achieving plasma concentrations of 24 +/- 3.2 to 35.5 +/- 4.5 micrograms/ml. NAPA did not significantly change sinus cycle length or atrioventricular (AV) conduction times (PA, AH, HV, and QRS), but it lengthened the QTc interval (p less than 0.001) during sinus rhythm. Programmed atrial stimulation revealed that NAPA had no discernible effects on AV nodal conduction; however, it exerted depressive effects on the His-Purkinje system in 9 of 16 patients. In 7 of 16 patients who manifested frequent ventricular premature beats (VPBs), NAPA abolished VPBs in only three of them; NAPA induced progressive prolongation of the premature coupling interval before complete abolition of VPBs. In 8 of 16 patients who had inducible repetitive ventricular response (RVR) because of reentry within the His-Purkinje system, NAPA narrowed or abolished the RVR zone in 3 patients and slowed the RVR rate with widening of the RVR zone in the remaining 5 patients. In 2 of 16 patients with slow ventricular tachycardia (VT), NAPA had no antiarrhythmic effects. By contrast, in the other 2 of 16 patients in whom sustained VT could be reproducibly elicited with programmed ventricular stimulation, NAPA slowed the rate of VT and suppressed VT inducibility. We conclude that electrophysiologic properties of NAPA are slightly different from those of procainamide and that NAPA is not uniformly effective for suppressing ventricular dysrhythmias, but its antiarrhythmic mechanisms are similar to those of procainamide.
R J Sung; Z Juma; S Saksena
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  105     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1983 May 
Date Detail:
Created Date:  1983-06-10     Completed Date:  1983-06-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  811-9     Citation Subset:  AIM; IM    
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MeSH Terms
Acecainide / administration & dosage,  therapeutic use*
Arrhythmias, Cardiac / drug therapy*,  physiopathology
Cardiac Complexes, Premature / drug therapy
Cardiac Pacing, Artificial
Heart Conduction System / drug effects*,  physiopathology
Middle Aged
Procainamide / analogs & derivatives*
Tachycardia / drug therapy
Reg. No./Substance:
32795-44-1/Acecainide; 51-06-9/Procainamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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