Antiarrhythmic Drug Therapy for Sporadic Ventricular Ectopic Arrhythmias

Exercise stress testing and 24-hour ambulatory monitoring have been employed to evaluate antiarrhythmic drug efficacy in patients with sporadic ventricular ectopic arrhythmias (VEA). Twenty-three patients with often recurring VEA were exercised 123 times and subjected to 66 ambulatory monitoring sessions during control periods and while receiving either procaine amide or quinidine. Two dose schedules were employed; procaine amide, 3.0 and 6.0 g daily and quinidine, 1.2 and 1.8 g daily. Though adequate and even high drug blood levels were reached, an effective antiarrhythmic response was observed in only eight patients receiving procaine amide and in seven of those taking quinidine. These modest successful results were associated with a high incidence of troublesome adverse effects which were noted in 11 patients receiving procaine amide and six of those receiving quinidine. It is concluded that these antiarrhythmic drugs should not be employed in the patient with episodic VEA unless the arrhythmias are symptomatic and are clearly life-threatening.