Prospective comparison of intravenous quinidine and intravenous procainamide in patients undergoing electrophysiologic testing.
BACKGROUND
Intravenous procainamide hydrochloride is frequently used in the acute care setting and during electrophysiologic testing, but intravenous quinidine gluconate is rarely used because of concerns about its safety. This study prospectively compares the hemodynamic and electrophysiologic effects of these agents in patients undergoing electrophysiologic testing.


RESULTS
Sixty-five consecutive patients with inducible ventricular tachyarrhythmias were prospectively treated with either intravenous quinidine gluconate or intravenous procainamide hydrochloride in an alternating unblinded fashion. The hemodynamic and electrophysiologic effects of these two drugs were compared. Seven (22%) patients assigned to intravenous quinidine gluconate and eight (24%) patients assigned to intravenous procainamide hydrochloride were rendered noninducible for ventricular tachyarrhythmias. Four (13%) patients assigned to intravenous quinidine gluconate were unable to complete the infusion compared with none (p = 0.05) assigned to intravenous procainamide hydrochloride. Otherwise, the overall hemodynamic and electrophysiologic effects of the two drugs were similar.


CONCLUSIONS
Intravenous quinidine gluconate is a reasonable alternative to intravenous procainamide hydrochloride in patients requiring a parenteral type IA antiarrhythmic agent.
Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
P T
PT
Holzberger
M L
ML
Greenberg
M C
MC
Paicopolis
T P
TP
Ozahowski
P C
PC
Ho
G T
GT
O'Connor
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011342:Procainamide / Q000008:administration & dosage* / Q000627:therapeutic use; D011446:Prospective Studies; D011802:Quinidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents; D011802:Quinidine; D011342:Procainamide; C016713:quinidine gluconate