August 1, 1981Circulation
Relationship between plasma levels of procainamide, suppression of premature ventricular complexes and prevention of recurrent ventricular tachycardia.
Key result
Procainamide plasma levels required for 85% PVC suppression were lower in AMI (5.0 µg/ml) than CIHD patients (9.3 µg/ml, p<0.05), and preventing VT required lower levels than suppressing PVCs.
Why the study?
Does the required plasma level of procainamide for PVC suppression differ among patients with AMI, CIHD, and recurrent VT, and is PVC suppression necessary to prevent VT?
Population
18 patients with ventricular arrhythmias
Design
Cohort
Authors
Discussion
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Implication
Procainamide dosing may need tailoring by cardiac condition; hypothesis-generating for VT prevention thresholds below full PVC suppression.
Key Points
- This research aims to explore how plasma levels of procainamide influence the suppression of premature ventricular complexes and prevention of ventricular tachycardia.
- Compared plasma levels of procainamide in 18 patients with different arrhythmia conditions.
- Measured levels associated with suppression of PVCs and prevention of VT episodes.
- Analyzed differences between patients with acute myocardial infarction and chronic ischemic heart disease.
- 85% suppression of PVCs in AMI patients required a mean level of 5.0 micrograms/ml (p<0.05).
- CIHD patients needed a mean level of 9.3 micrograms/ml for similar suppression (p<0.05).
- In VT patients, mean plasma levels of 9.1 micrograms/ml prevented symptomatic VT episodes, with PVC suppression not critical for preventing VT.
Study Design
Type
Observational (n=18)
Structured PICO
Does the required plasma level of procainamide for PVC suppression differ among patients with AMI, CIHD, and recurrent VT, and is PVC suppression necessary to prevent VT?
P
Population
18 patients with ventricular arrhythmias (6 with premature ventricular complexes [PVCs] during acute myocardial infarction [AMI], 6 with PVCs in stable chronic ischemic heart disease [CIHD], and 6 with recurrent symptomatic ventricular tachycardia [VT] and chronic PVCs)
I
Intervention
Procainamide
O
Outcome
Plasma levels of procainamide required for 85% suppression of PVCs or prevention of spontaneous episodes of symptomatic sustained tachycardiasurrogate
Main Result
Absolute Event Rate: 5% vs 9.3%
p-value: p=<0.05
The plasma level of procainamide required for PVC suppression varies by underlying cardiac condition, and a high degree of PVC suppression is not necessary to protect patients against recurrent symptomatic VT.
Cite This Study
Myerburg et al. (1981) conducted an observational in Ventricular arrhythmias (n=18). Procainamide vs. AMI vs CIHD patients was evaluated on Plasma level of procainamide required for 85% suppression of PVCs (p=<0.05). Procainamide plasma levels required for 85% PVC suppression were lower in AMI (5.0 µg/ml) than CIHD patients (9.3 µg/ml, p<0.05), and preventing VT required lower levels than suppressing PVCs.