The Wolff-Parkinson-White syndrome: Pharmacologic effects of procaine amide

Occurrence of intermittent Wolff-Parkinson-White syndrome during intravenous sedation

“…However, therapeutic agents for supraventricular tachycardia must be prepared and made available. Vagal maneuvers or drugs may be necessary to treat supraventricular tachycardia when it does occur [22][23][24]. In cases with narrow QRS tachycardia, the administration of adenosine should be considered if vagal maneuvers were not effective.…”

Wolff-Parkinson-White syndrome. Circus movement tachycardia dependent on procainamide.

“…Thus the initiation of tachycardia by premature stimuli was prevented in 6 of 10 patients given procainamide, quinidine, or ajmaline, studied by Wellens and Durrer (1974) and in 6 of 9 patients given procainamide reported by Mandel et al (1975). However, Wellens and Durrer predicted that drugs that selectively prolong the refractory period of the accessory pathway may also widen the range of premature beat intervals at which tachycardia can be initiated.…”

“…The effects of antiarrhythmic drugs on conduction through accessory atrioventricular pathways and on the induction of tachycardia by atrial or ventricular stimulation have recently been recorded (Wellens and Durrer, 1974;Mandel et al, 1975). This report concerns a patient with pre-excitation and life-threatening atrial arrhythmia.…”

“…Circus tachycardia was induced by atrial stimulation only after the administration of procainamide. Nevertheless, treatment with this drug controlled the ventricular rate and spontaneous circus tachycardia did not occur.The effects of antiarrhythmic drugs on conduction through accessory atrioventricular pathways and on the induction of tachycardia by atrial or ventricular stimulation have recently been recorded (Wellens and Durrer, 1974;Mandel et al, 1975 However, monitoring indicated that the spontaneous cessation of paroxysmal atrial flutter or, at times, fibrillation was followed by asystole which was often of sufficient duration to cause loss of consciousness. That digitalis was a factor in causing sinus node dysfunction was proved by withdrawal and subsequent rechallenge with digoxin.…”

Effects of procainamide and quinidine sulfate in the Wolff-Parkinson-White syndrome.

“…When pacing the CS, preliminary pacing at a slow rate was always done first to be sure that the left ventricle was not actually being paced through the wall of the coronary sinus. Following the completion of these control studies, procainamide, [10][11][12] Of the 18 patients who received both procainamide and quinidine, 14/18 had more prolongation of the minimum R-R interval (30-100 msec) on quinidine than on procainamide. Of these 14, two patients (TJ, JC) had atrial flutter while on procainamide and atrial fibrillation while on quinidine; however, the ventricular response during atrial fibrillation while on quinidine was slower than that with atrial flutter while on procainamide.…”