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The effects of programmed ventricular stimulation on plasma procainamide levels: an experimental model
R T Brautigam1, S Porter, S P Kutalek
1Cardiac Electrophysiology Laboratory, Likoff Cardiovascular Institute, Hahnemann University Hospital, Philadelphia, Pennsylvania.
Journal of Clinical Pharmacology
|February 1, 1994
Summary
Programmed ventricular stimulation increased plasma concentrations of procainamide by 10-12% in dogs post-myocardial infarction. This finding is crucial for understanding antiarrhythmic drug efficacy and dosing in cardiac patients.
Area of Science:
- Pharmacology
- Cardiology
- Clinical Electrophysiology
Background:
- Myocardial infarction can alter drug pharmacokinetics.
- Programmed ventricular stimulation is used to assess arrhythmia risk.
Purpose of the Study:
- To investigate the effect of programmed ventricular stimulation on procainamide plasma concentrations.
- To determine if ventricular stimulation impacts drug levels in dogs with prior myocardial infarction.
Main Methods:
- 12 dogs with myocardial infarction underwent procainamide dosing on two separate days.
- Ventricular stimulation was performed on one day, but not the other.
- Plasma procainamide concentrations were measured at sequential plateau levels during stimulation.
Main Results:
- Mean plasma procainamide concentrations were 10% and 12% higher during stimulation at two dosage levels (P < 0.02 and P < 0.005).
- No lethal ventricular arrhythmias were induced in the analyzed subjects.
Conclusions:
- Programmed ventricular stimulation can significantly increase procainamide plasma concentrations.
- These findings suggest potential adjustments in antiarrhythmic drug dosing strategies in patients undergoing electrophysiological studies.