Electrophysiologic Effects of Procaine Amide in Patients with Intraventricular Conduction Delay

Our study is unique in that we studied the electrophysiologic effects of procaine amide in patients with IV conduction disturbances

MELVIN M. SCHEINMAN; ALAN N. WEISS; EUGENE SHAFTON; NEAL BENOWITZ; MALCOLM ROWLAND

2012

Scholarcy highlights

  • Plasma concentration of procaine amide rose to a mean peak level of 10.2 + 3.4
  • A slight decline in plasma drug level occurred in some patients between 20 and 22 min and was probably due to a slight delay in synchronizing blood sampling at the actual completion of infusion
  • Change in H-Q intervals between patients, changes in His-Purkinje conduction were parallel with the rising procaine amide concentration, and maximal prolongation always occurred at the time of peak drug concentration
  • The mean percent maximal lengthening of the H-Q interval was 18%. These findings are in close agreement with those of previous studies of patients with normal A-V nodal and IV conduction.5' 6 In the present study, the degree of H-Q prolongation could not be predicted on the basis of control QRS duration, bundle branch block pattern, H-Q interval, or peak procaine amide level achieved
  • The mean infranodal conduction time at peak procaine amide was significantly higher than control measurements, with a mean percent increase of 18%, and maximal prolongation of H-Q occurred at peak PA blood levels
  • Our study demonstrated that acute intravenous infusions of procaine amide as administered in the study produced clinically effective plasma levels and were safe for patients with IV conduction disturbances in that no high degree of A-V block, ventricular ectopic beats or cardiac asystole resulted from procaine amide administration
  • Most of the patients had prolongation of infranodal conduction at the peak procaine amide concentration, the magnitude of change was generally small and probably of little clinical significance

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