Clinical use of sustained-release procainamide in treatment of cardiac arrhythmias

Although procainamide has been available, and used, in the treatment of atrial and ventricular arrhythmias for approximately thirty years, its short half-life has made it less than optimal for long-term arrhythmia management in ambulatory patients. Currently available sustained-release preparations provide the same therapeutic benefit with a more tolerable dosage schedule. The pharmacology of procainamide and its basic electrophysiologic properties, dosage schedules, and toxicity are discussed. Finally, the current indications for its use are reviewed.