Procaine amide compared with quinidine as a therapy for arrhythmias

Abstract

In a previous report 1 it was shown that procaine amide is clinically effective in the treatment of auricular arrhythmias. The present report attempts to answer two questions: 1. 1. What is the clinical value of procaine amide in the treatment of arrhythmias? Until now quinidine has been the drug of choice. How does procaine amide compare with it clinically? 2. 2. Does procaine amide have a preferential effect on ventricular arrhythmias as compared to auricular? This has been inferred by those 2 who claim that it is clinically effective only in patients with ventricular and not in patients with auricular arrhythmias. This study attempts to ascertain any preferential effect. This can be done by comparing it quantitatively with quinidine in both types of cases. It is reasonable to assume that quinidine acts equally well on both types of arrhythmias. If procaine amide is more effective in the ventricular variety, then the ratio, effective dose of procaine amide/ effective dose of quinidine, should be smaller in a case of ventricular extrasystoles or tachycardia than in a case of auricular extrasystoles or fibrillation. If there is no preferential action, then the ratio should be the same for both types of cases. The effect of different doses of the two drugs was measured in two patients with a ventricular arrhythmia and in one patient with an auricular arrhythmia. The above ratio was estimated for each case. The results fail to show any preferential effectiveness on the ventricular variety.