Evaluation of an Open‐Loop, Computer‐Based Infusion System Designed to Achieve a Series of Constant, Targeted Plasma Procainamide Concentrations in Patients Undergoing Electrophysiologic Testing

Abstract

Study Objective. To evaluate the performance of a computer‐based procainamide infusion system in patients undergoing electrophysiologic testing.Design. Prospective case series.Setting. Electrophysiology laboratory in a university hospital.Patients. Thirty‐four patients with inducible sustained ventricular tachycardia.Interventions. Intravenous infusion of procainamide to achieve and maintain targeted plasma concentrations.Measurements and Main Results. System performance was assessed by comparing targeted and observed plasma concentrations. The population median absolute performance error (size of typical miss) was 12.6% (95% CI 11.2–14.1%). The population median performance error (system bias) was not significantly different from zero. A small but statistically significant improvement in performance over time was observed (population absolute performance error divergence −0.125%/min). Population wobble (overall system stability) was 7.6% (95% CI 6.8–8.3%). Population‐based estimates of central compartment volume and volume of distribution at steady state were significantly higher and lower, respectively, than estimates used by the infusion system.Conclusion. The computer‐based infusion system is capable of achieving and maintaining a series of targeted procainamide concentrations in patients undergoing electrophysiologic testing.