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Procainamide works as an anti-arrhythmic agent and is used to treat cardiac arrhythmia. It induces rapid block of the batrachotoxin (BTX)-activated sodium channels of the heart muscle and acts as antagonist to long-gating closures. The block is voltage-dependent and can occur from both sides; either from the intracellular or the extracellular side.
They thus reduce the contractility of the heart, so may be inappropriate in heart failure. However, in contrast to beta blockers, they allow the body to retain adrenergic control of heart rate and contractility. [citation needed] Class IV agents include verapamil and diltiazem.
Steady-state procainamide and acecainide concentrations were used to compute procainamide clearance and acecainide/procainamide (NAPA/PA) concentration ratio. Using stepwise multiple linear regression age, creatinine clearance and congestive heart failure were found to influence procainamide clearance significantly (p less than 0.05).
While procainamide and quinidine may be used in the conversion of atrial fibrillation to normal sinus rhythm, they should only be used in conjunction with an AV node blocking agent such as digoxin or verapamil, or a beta blocker, because procainamide and quinidine can increase the conduction through the AV node and may cause 1:1 conduction of ...
Automatic junctional tachycardia is treated clinically when there are symptoms, hemodynamic compromise, ventricular dysfunction, congestive heart failure, or evidence of hydrops in fetal cases. Amiodarone , beta-blockers , sotalol , flecainide , procainamide , digoxin , and anti-inflammatory agents such as steroids or even colchicine are ...
Structural heart disease, such as heart failure, myocardial infarction, and left ventricular hypertrophy, are also risk factors. Diuretic-induced hypokalemia and/or hypomagnesemia taken for heart failure can induce proarrthymia. The ischemia that results from myocardial infarctions also induce QT prolongation. [citation needed]
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