Procainamide infusion and acute atrial fibrillation

Area of Science:

• Cardiology
• Pharmacology

Background:

• Acute atrial fibrillation is a common arrhythmia requiring prompt management.
• Cardioversion is a key strategy to restore normal sinus rhythm.

Purpose of the Study:

• To evaluate the safety and efficacy of intravenous procainamide infusion for acute atrial fibrillation cardioversion.

Main Methods:

• Fifteen patients with acute atrial fibrillation received procainamide infusion at 50 mg/min, up to 20 mg/kg.
• Continuous electrocardiographic and blood pressure monitoring was performed during infusion.

Main Results:

• Ten out of fifteen patients responded to procainamide infusion.
• The mean effective dose was 8.7 mg/kg; four patients converted to sinus rhythm at doses below 5.0 mg/kg.
• Hypotension occurred in four patients, necessitating infusion termination in only one case (cardiomyopathy).

Conclusions:

• Intravenous procainamide infusion is a safe and moderately effective treatment option for cardioversion in acute atrial fibrillation.
• Adverse events like hypotension are manageable, and no significant proarrhythmic effects were observed.