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Procainamide‐Induced Incessant Supraventricular Tachycardia in the Wolff‐Parkinson‐White Syndrome
Author(s) -
ELDAR MICHAEL,
RUDER MICHAEL A.,
DAVIS JESSE C.,
ABBOTT JOSEPH A.,
SEGER JOHN,
GRIFFIN JERRY C.,
SCHEINMAN MELVIN M.
Publication year - 1986
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1986.tb05412.x
Subject(s) - procainamide , orthodromic , medicine , tachycardia , supraventricular tachycardia , cardiology , atrioventricular node , accessory pathway , refractory period , anesthesia , catheter ablation , electrophysiology , atrial fibrillation
A patient with the Wolff‐Parkinson‐While syndrome presented with incessant orthodromic atrioventricular tachycardia following initiation of procainamide therapy. This finding was repeatedly documented both clinically as well as during electrophysiologic testing. Escape atrial complexes, which occurred following junctional premature complexes, failed to initiate tachycardia in the control state but tachycardia was always reinitiated by an identical escape sequence after procainamide. In addition, the tachycardia persisted and was repeatedly spontaneously reinitiated for prolonged periods after procainamide. The pro‐arrhythmic effects of procainamide may be explained on the basis of both its vagolytic action on the atrioventricular node as well as by prolongation of refractoriness in the accessory pathway. These observations add to the literature on pro‐arrhythmic effects of commonly used antiarrhythmic drugs.