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Procainamide (PCA) is a medication of the antiarrhythmic class used for the treatment of cardiac arrhythmias. It is a sodium channel blocker of cardiomyocytes; thus it is classified by the Vaughan Williams classification system as class Ia. In addition to blocking the I Na current, it inhibits the I Kr rectifier K+ current. [1]
(The re-entrant rhythm is less likely to interact with tissue that has become refractory). The class III agents exhibit reverse-use dependence (their potency increases with slower heart rates, and therefore improves maintenance of sinus rhythm). Inhibiting potassium channels results in slowed atrial-ventricular myocyte repolarization.
Indications for Class Ia agents are supraventricular tachycardia, ventricular tachycardia, symptomatic ventricular premature beats, and prevention of ventricular fibrillation. Procainamide can be used to treat atrial fibrillation in the setting of Wolff–Parkinson–White syndrome , and to treat wide complex hemodynamically stable tachycardias .
However, the clearance of acecainide was reduced in a few patients with cardiomyopathyand and ventricular arrhythmias. Also is excretion of procainamide and NAPA is reduced in patients with CKD. [14] A major reaction to procainamide and several other drugs is a syndrome that closely resembles lupus.
Proarrhythmia is a new or more frequent occurrence of pre-existing arrhythmias, paradoxically precipitated by antiarrhythmic therapy, which means it is a side effect associated with the administration of some existing antiarrhythmic drugs, as well as drugs for other indications. In other words, it is a tendency of antiarrhythmic drugs to ...
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