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Procainamide-induced polymorphous ventricular tachycardia

B Strasberg, S Sclarovsky, A Erdberg

    The American Journal of Cardiology
    |June 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

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    Procainamide can cause acquired long QT syndrome and polymorphous ventricular tachycardia, even with oral administration. This serious cardiac arrhythmia can lead to syncope, ventricular fibrillation, and death.

    Area of Science:

    • Cardiology
    • Clinical Electrophysiology
    • Pharmacology

    Background:

    • Procainamide is an antiarrhythmic drug used to treat various cardiac arrhythmias.
    • Polymorphous ventricular tachycardia (PVT) is a potentially life-threatening arrhythmia characterized by a shifting QRS axis.

    Observation:

    • Seven cases of procainamide-induced PVT are presented, occurring after both intravenous and oral administration.
    • Patients exhibited QT prolongation and experienced syncope due to PVT.
    • Two patients developed irreversible ventricular fibrillation and died, while one patient with a pacemaker did not experience recurrence.

    Findings:

    • Procainamide administration, at doses of 200-400 mg IV or orally, can induce acquired long QT syndrome.
    • This syndrome predisposes patients to potentially fatal polymorphous ventricular tachycardia.

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  • Prompt diagnosis and treatment can resolve episodes, but outcomes vary, including mortality.

    • Implications:

    • Clinicians should be aware of the risk of procainamide-induced long QT syndrome and PVT.
    • Careful patient monitoring is crucial during procainamide therapy, especially in those with pre-existing QT prolongation risk factors.
    • Alternative antiarrhythmic strategies may be necessary for patients susceptible to procainamide-induced arrhythmias.