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Intermittent Intravenous Procaine Amide to Treat Ventricular Arrhythmias: Correlation of Plasma Concentration with Effect on Arrhythmia, Electrocardiogram, and Blood Pressure

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Supported in part by U.S. Public Health Service grants HE 05741 and HE 12738 and by a grant-in-aid from the New York Heart Association. Dr. Giardina is a Fellow of the New York Heart Association; this work was initiated while she was a National Heart and Lung Institute Trainee, grant 5-T12-HE 05864, and continued as a Special Fellow, National Institutes of Health and U.S. Public Health Service grant IF 03-HE 50709-01. Dr. Bigger is a recipient of a Research Career Development Award from the National Heart and Lung Institute (1-KO4-HL-70204); this work was begun during his tenure as Senior Investigator, New York Heart Association.

▸Address reprint requests to Elsa-Grace V. Giardina, M.D., Department of Medicine, College of Physicians and Surgeons, 630 West 168th St., New York, N.Y. 10032.

New York, New York

Ann Intern Med. 1973;78(2):183-193. doi:10.7326/0003-4819-78-2-183
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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.





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