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PROCAINE amide was introduced for the treatment of cardiac arrhythmias 6 years ago.Since then a number of studies with the compound have been reported.A review of the results may help in appraising the value of the drug as a therapeutic agent.The first step toward the development of procaine amide was taken when Mautz,' in 1936, showed that procaine, applied directly to the myocardium of animals, elevated the threshold of ventricular muscle to electric stimulation.Beck and Mautz2 then demon- strated that the topical application of procaine in surgery involving stripping of the peri- cardium, reduced the occurrence of ventricular and atrial extrasystoles.In 1946, Burstein3 reported that procaine was an effective anti- arrhythmic agent when injected intrave- nously, and he employed it in anesthetized patients prophylactically as well as thera- peutically.Although of undoubted effective antiarrhythmic activity, procaine has limited use in the general treatment of arrhythmias because of its central stimulatory effects, which restrict its use to anesthetized patients.A study on the fate of procaine in man showed that the drug after intravenous injection was enzymatically hydrolysed in plasma with extreme rapidity to para-aminobenzoic acid and diethylaminoethanol.4The rapid hydrolysis of procaine suggested that its anti- arrhythmic action might be mediated through one of the metabolites.Para-aminobenzoic acid was found to have no antiarrhythmic
Kayden et al. (Tue,) studied this question.