Management of atrial tachyarrhythmias in the critically ill: A comparison of intravenous procainamide and amiodarone

Chapman, Matthew; Moran, J. L.; O'Fathartaigh, M. S.; Peisach, A R; Cunningham, D. N.

doi:10.1007/bf01709278

Cited by 62 publications

(33 citation statements)

References 13 publications

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“…76 Interestingly, in both studies, early (1 hour) conversion rates were significantly better with propafenone, suggesting a more delayed onset of action with amiodarone. Other small, randomized studies of acute AF conversion have found intravenous amiodarone to be similar to intravenous procainamide, 77 and in 1 trial, significantly less effective than magnesium sulfate. 78 Primary prevention of AF is a worthwhile goal that has been studied in 1 heart failure trial and extensively in patients recovering from open-heart surgery, in whom AF occurs in about 30% of patients.…”

Section: Amiodarone For Afmentioning

confidence: 88%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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Section: Amiodarone For Afmentioning

confidence: 88%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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“…Chapman et al 8 showed equal efficacy between amiodarone and procainamide in the management of atrial tachyarrhythmias among critically ill adults (71% effective for amiodarone compared with 70% for procainamide with no significant differences in time to conversion or AEs). The appropriateness of extrapolating this data to pediatric patients, who have both varied arrhythmic substrates and presumably different medication effects, is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…In recurrent or refractory SVT, both intravenous amiodarone and procainamide have been administered, with variable success rates reported in the literature. [1][2][3][4][5][6][7][8] No studies to date, however, have compared these 2 medications in terms of efficacy and safety in the treatment of pediatric patients with SVT. The purpose of this study was to (1) compare the treatment efficacy of amiodarone versus procainamide in pediatric patients with recurrent SVT and (2) compare the adverse effects associated with the use of these 2 medications.…”

Section: Editorial See Page 115 Clinical Perspective On P 140mentioning

confidence: 99%

Amiodarone Versus Procainamide for the Acute Treatment of Recurrent Supraventricular Tachycardia in Pediatric Patients

Chang

Silka

Moromisato

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background-Intravenous amiodarone and procainamide are both used as therapies for refractory supraventricular tachycardia (SVT). However, no studies have compared the efficacy and safety of these agents in pediatric patients. Methods and Results-All patients treated with intravenous amiodarone or procainamide during 25 consecutive months for the following mechanisms of SVT were included: orthodromic reciprocating tachycardia, intra-atrial reentrant tachycardia, and ectopic atrial tachycardia; junctional ectopic tachycardia was excluded. Treatment response was categorized as full success, partial success, or failure. Partial success was defined as clinical improvement and/or arrhythmia control but not meeting full success criteria. Adverse events were classified as major (requiring resuscitation) or minor (management changes). There were 40 episodes of SVT in 37 patients (median age, 34 days; 24 with congenital heart disease). Amiodarone was the initial therapy in 26 cases and procainamide in 14 cases. If partial and full success are combined, procainamide was successful in 71% of cases compared with 34% for amiodarone (Pϭ0.046). If partial success is considered a treatment failure, procainamide was successful in 50% compared with 15% for amiodarone (Pϭ0.029). Ten patients received the second medication after the first failed. Success was achieved in 5 of 8 amiodarone-to-procainamide crossovers compared with 1 of 2 procainamide-to-amiodarone crossovers. One major and 10 minor adverse events occurred in amiodarone patients versus 6 minor adverse events in procainamide patients (PϭNS). Conclusions-In this cohort, procainamide achieved greater success compared with amiodarone in the management of recurrent SVT without statistically significant differences in adverse event frequency. (Circ Arrhythm Electrophysiol.

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“…The drug was also found to be inferior to ibutilide in conversion of both atrial flutter (14% vs. 76%) and atrial fibrillation (21% vs. 51%) [17]. There was no difference in conversion efficacy of atrial tachycardia for procainamide vs. amiodarone in the critically ill (71% vs. 70%) [21].…”

Section: Class Ia Antiarrhythmic Medications Procainamidementioning

confidence: 99%

Antiarrhythmic Medications for Cardioversion and Maintenance of Sinus Rhythm in Patients with Cardiac Arrhythmias: A Review of the Literature

En¹,

Sk²

2017

Cardiovasc Pharm Open Access

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Introduction: Cardiac arrhythmias, including supraventricular and ventricular tachycardias, portend a higher risk of morbidity and mortality. These arrhythmias also are associated with increased healthcare resource utilization, decreased quality of life, and increased activity impairment. Pharmacologic conversion is a treatment option for conversion to sinus rhythm that has the advantage of avoiding sedation from DC cardioversion.

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Management of atrial tachyarrhythmias in the critically ill: A comparison of intravenous procainamide and amiodarone

Abstract: Procainamide and amiodarone appear to be safe and equally effective in the treatment of AT in the critically ill.

Cited by 62 publications

References 13 publications

Evidence-Based Analysis of Amiodarone Efficacy and Safety

Evidence-Based Analysis of Amiodarone Efficacy and Safety

Amiodarone Versus Procainamide for the Acute Treatment of Recurrent Supraventricular Tachycardia in Pediatric Patients

Antiarrhythmic Medications for Cardioversion and Maintenance of Sinus Rhythm in Patients with Cardiac Arrhythmias: A Review of the Literature

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