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Thirty-three patients with sustained ventricular arrhythmias underwent electrophysiologic testing after intravenous and again after oral procainamide administration. Two groups were identified: group 1 included 15 patients with concordant serum procainamide concentrations with less than a 3 micrograms/ml difference after intravenous (mean 8.6 +/- 2.7) and oral (mean 8.8 +/- 2.7) procainamide administration, with mean N-acetylprocainamide concentrations of 1.0 +/- 0.6 and 6.2 +/- 2.8 micrograms/ml, respectively. Group 2 included 18 patients with discordant serum procainamide concentrations after intravenous (mean 9.5 +/- 5.9 micrograms/ml) and oral (mean 14.1 +/- 5.2 micrograms/ml) procainamide, with mean N-acetylprocainamide concentrations of 0.9 +/- 0.5 and 10.7 +/- 5.7 micrograms/ml, respectively. In group 1, response to programmed stimulation was the same after intravenous and oral procainamide administration, with no inducible ventricular arrhythmia in 5 of 15 patients. In group 2, 3 of 18 patients had no inducible arrhythmia after intravenous compared with 7 of 18 patients after oral procainamide administration. There was a different response to programmed stimulation after oral compared with intravenous procainamide in 6 of 18 patients in group 2 but in none of 15 patients in group 1 (p = 0.02). The effective procainamide concentration was greater than the ineffective concentration in five of the six patients with a discordant response, and the effective route of administration was oral in five of the six patients. The change in ventricular refractoriness in group 1 was similar after intravenous (28 +/- 23 ms) and oral (29 +/- 19 ms) procainamide, whereas in group 2, refractoriness was increased more after oral (33 +/- 21 ms) than intravenous (20 +/- 17 ms) procainamide administration and paralleled the difference in procainamide concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
March 1992,
Annals of internal medicine,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
June 1991,
Journal of the American College of Cardiology,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
May 1985,
American heart journal,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
January 1988,
Drug intelligence & clinical pharmacy,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
January 1977,
European journal of clinical pharmacology,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
May 1988,
The American journal of cardiology,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
March 1991,
Pacing and clinical electrophysiology : PACE,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
November 1982,
American heart journal,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
January 1977,
Postgraduate medical journal,
F E Marchlinski, and
A E Buxton, and
J A Vassallo, and
H L Waxman, and
D M Cassidy, and
J U Doherty, and
M E Josephson
January 1990,
The Canadian journal of cardiology,
