Key result
Ajmaline eliminated premature ventricular systoles at small doses and, when combined with procaine amide to prevent A-V block, converted chronic atrial fibrillation to sinus rhythm briefly.
Why the study?
Does intravenous ajmaline affect cardiac rhythm in patients with chronic atrial fibrillation?
Does intravenous ajmaline affect cardiac rhythm in patients with chronic atrial fibrillation?
Intravenous ajmaline can suppress premature ventricular systoles and, when combined with procaine amide to prevent A-V block, temporarily convert chronic atrial fibrillation to sinus rhythm.
Should not yet change practice in chronic AF; this Level 5 case leaves open ajmaline's role pending controlled trials.
AjmaTine, an alkaloid which contains the quinuclidine ring, is closely related to quinidine; in quinidine, the quinuclidine ring is joined to quinoline, while in ajmaline, which is derived from a species of Rauwolfia, it is combined with the reputedly less toxic indole nucleus. Ajmaline was administered by slow intravenous drip to patients with chronic, sustained atrial fibrillation, some of whom also had frequent premature ventricular sY5toles. Small doses of ajmaline eliminated the premature ventricular systoles although the atrial arrhythmia persisted. Larger doses of ajmaline restored normal P wave activity, but complete A‐V block developed. When A‐V block was prevented by small doses of procaine amide, ajmaline converted atrial fibrillation to regular sinus rhythm for short periods.
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Dick et al. (1963) studied Chronic, sustained atrial fibrillation. Ajmaline was evaluated on Conversion of atrial fibrillation to regular sinus rhythm and elimination of premature ventricular systoles. Ajmaline eliminated premature ventricular systoles at small doses and, when combined with procaine amide to prevent A-V block, converted chronic atrial fibrillation to sinus rhythm briefly.
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