Antiarrhythmic drug efficacy at electrophysiology testing: predictive effectiveness of procainamide and flecainide.
Publication/Presentation Date
4-1-1986
Abstract
In an effort to assess the ability of procainamide to predict effectiveness of antiarrhythmic agents at programmed electrical stimulation (PES) testing, we compared the result of procainamide at PES testing with that of all of the other agents studied. One hundred fifty-three patients underwent PES studies because of either sustained or nonsustained ventricular tachycardia (VT). Procainamide prevented VT induction in 79 of 153 patients. Seventy-four of the remaining 153 were inducible for VT on procainamide, with 55 of these being protected by another antiarrhythmic agent (p less than 0.001). If procainamide failed to prevent VT induction, other conventional and experimental agents were equally as likely to be effective in preventing VT induction. Analysis of flecainide acetate as a predictor of efficacy was also evaluated. Fifty-five patients received flecainide and 29 of these were protected at PES testing; 26 of these patients were also protected with another agent. When VT was inducible in patients who received flecainide, 15 of these 26 patients were protected by another agent, either conventional or experimental (p less than 0.01). Thus, if procainamide or flecainide prevented VT induction they accurately predicted effectiveness of other drugs; however, when they did not prevent VT induction, they served as a poor predictor of the possible effectiveness of other drugs. Serial drug testing at PES studies with multiple conventional and experimental drugs increases the likelihood of finding an effective antiarrhythmic agent.
Volume
111
Issue
4
First Page
632
Last Page
638
ISSN
0002-8703
Published In/Presented At
Wynn, J., Torres, V., Flowers, D., Mizruchi, M., Keefe, D., Miura, D., & Somberg, J. (1986). Antiarrhythmic drug efficacy at electrophysiology testing: predictive effectiveness of procainamide and flecainide. American heart journal, 111(4), 632–638. https://doi.org/10.1016/0002-8703(86)90090-6
Disciplines
Medicine and Health Sciences
PubMedID
3953384
Department(s)
Department of Medicine
Document Type
Article