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Limitations of failure of procainamide during electrophysiologic testing to predict response to other medical therapy
Journal article   Open access   Peer reviewed

Limitations of failure of procainamide during electrophysiologic testing to predict response to other medical therapy

Alan P. Rae, Neil M. Sokoloff, Charles R. Webb, Scott R. Spielman, Allan M. Greenspan and Leonard N. Horowitz
Journal of the American College of Cardiology, v 6(2), pp 410-416
Aug 1985
DOI: https://doi.org/10.1016/S0735-1097(85)80180-7
PMID: 4019928
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/s0735-1097(85)80180-7View
Published, Version of Record (VoR) Open

Abstract

To determine whether failure of procainamide to prevent initiation of ventricular tachyarrhythmias during electrophysiologic testing predicted failure of other antiarrhythmic regimens, 81 consecutive patients with coronary artery disease whose ventricular tachyarrhythmias remained inducible during procainamide administration were studied. Overall, 26 (12%) of 216 subsequent drug studies were successful and at least one effective drug regimen was identified in 22 (27%) of the 81 patients. Drug success was significantly related to the arrhythmia induced at baseline study; 7% of drug studies were successful in patients with sustained ventricular tachycardia, 24% in patients with ventricular fibrillation, and 29% in patients with nonsustained ventricular tachycardia. An effective drug regimen was found in 11(19%) of 59 patients with sustained ventricular tachycardia, 4 (50%) of 8 patients with ventricular fibrillation and 7 (50%) of 14 patients with nonsustained ventricular tachycardia. In patients with sustained ventricular tachycardia, failure of procainamide to suppress the arrhythmia correlated with failure of other agents used singly but not in combination. This study supports the view that when procainamide fails to prevent initiation of the arrhythmia in patients with inducible sustained ventricular tachycardia it is unlikely that other individual standard agents will be effective. However, combination regimens may suppress the arrhythmia and should be evaluated. In patients with nonsustained ventricular tachycardia, all agents should be evaluated because failure to respond to procainamide does not predict subsequent responses to other agents either alone or in combination.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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