Intermittent Intravenous Procaine Amide to Treat Ventricular Arrhythmias

Abstract

Twenty patients with ventricular arrhythmias were treated with procaine amide to determine an antiarrhythmic plasma drug concentration range and to observe procaine amide's effect on blood pressure and the electrocardiogram. Each received 100 mg of procaine amide intravenously every 5 minutes until arrhythmia was abolished, 1 g of drug was given, or untoward drug effects appeared. Arrhythmia was abolished in 17 patients and partially suppressed in 2 patients at a plasma drug concentration between 4 and 10 µg/ml; 1 patient did not respond. Therapy never had to be interrupted because of drug-induced hypotension, atrioventricular or intraventricular conduction disturbances, or arrhythmias. A strong linear relation was found between plasma procaine amide concentration and cumulative dose:- plasma procaine amide concentration (µg/ml) = 0.84 + 0.73x, where x is the cumulative procaine amide dose (mg/kg body weight). Intermittent intravenous procaine amide administration rapidly and safely produces antiarrhythmic plasma drug concentrations.