Value of the ajmaline-procainamide test to predict the effect of long-term oral amiodarone on the anterograde effective refractory period of the accessory pathway in the Wolff-Parkinson-White syndrome.
In patients with the Wolff-Parkinson-White syndrome, intravenous ajmaline (50 mg administered over 3 minutes) or procainamide (10 mg/kg body weight administered over 10 minutes) is helpful in defining the duration of the anterograde effective refractory period of the accessory pathway. In this study the value of the ajmaline-procainamide test to predict the effects on the anterograde effective refractory period of the accessory pathway of long-term oral amiodarone were assessed. Thirty-six patients with the Wolff-Parkinson-White syndrome were studied. Twenty-four (Group A) had a negative result of the ajmaline-procainamide test and a mean duration of the anterograde effective refractory period of the accessory pathway of 237 +/- 24 ms. Twelve (Group B) had a positive result in the ajmaline-procainamide test (disappearance of preexcitation during sinus rhythm after administration of ajmaline and procainamide) and a duration of the anterograde effective refractory period of the accessory pathway of 284 +/- 25 ms (p less than 0.05 versus values in Group A). Amiodarone prolonged the anterograde effective refractory period of the accessory pathway by 53 +/- 35 ms in patients in Group A to 290 +/- 37 ms (p less than 0.001) and by 100 +/- 85 ms in patients in Group B to 384 +/- 94 ms (p less than 0.001). The difference in mean increase between both groups was not significant. In most patients (83%) in Group A amiodarone prolonged the anterograde effective refractory period of the accessory pathway to 260 to 330 ms. However, in most patients (83%) in Group B, amiodarone prolonged the anterograde effective refractory period of the accessory pathway to greater than or equal to 330 ms (p less than 0.01). Thus, an ajmaline-procainamide test is of value in predicting the results of oral amiodarone on the anterograde effective refractory period of the accessory pathway.
D000293:Adolescent; D000328:Adult; D000404:Ajmaline; D000638:Amiodarone / Q000494:pharmacology*; D001572:Benzofurans / Q000494:pharmacology*; D004594:Electrophysiology; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011342:Procainamide; D013997:Time Factors; D014927:Wolff-Parkinson-White Syndrome / Q000188:drug therapy*
D001572:Benzofurans; D000404:Ajmaline; D011342:Procainamide; D000638:Amiodarone