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Randomized Controlled Trial
. 2017 May 1;38(17):1329-1335.
doi: 10.1093/eurheartj/ehw230.

Randomized comparison of intravenous procainamide vs. intravenous amiodarone for the acute treatment of tolerated wide QRS tachycardia: the PROCAMIO study (VSports注册入口)

Mercedes Ortiz  1 , Alfonso Martín  2 , Fernando Arribas  3 , Blanca Coll-Vinent  4 , Carmen Del Arco  5 , Rafael Peinado  6 , Jesús Almendral  1 ; PROCAMIO Study Investigators
Affiliations
Randomized Controlled Trial

Randomized comparison of intravenous procainamide vs. intravenous amiodarone for the acute treatment of tolerated wide QRS tachycardia: the PROCAMIO study

Mercedes Ortiz et al. Eur Heart J. .

Abstract

Aims: Intravenous procainamide and amiodarone are drugs of choice for well-tolerated ventricular tachycardia VSports手机版. However, the choice between them, even according to Guidelines, is unclear. We performed a multicentre randomized open-labelled study to determine the safety and efficacy of intravenous procainamide and amiodarone for the acute treatment of tolerated wide QRS complex (probably ventricular) tachycardia. .

Methods and results: Patients were randomly assigned to receive intravenous procainamide (10 mg/kg/20 min) or amiodarone (5 mg/kg/20 min). The primary endpoint was the incidence of major predefined cardiac adverse events within 40 min after infusion initiation. Of 74 patients included, 62 could be analysed. The primary endpoint occurred in 3 of 33 (9%) procainamide and 12 of 29 (41%) amiodarone patients (odd ratio, OR = 0. 1; 95% confidence interval, CI 0. 03-0. 6; P = 0. 006). Tachycardia terminated within 40 min in 22 (67%) procainamide and 11 (38%) amiodarone patients (OR = 3. 3; 95% CI 1. 2-9. 3; P = 0. 026). In the following 24 h, adverse events occurred in 18% procainamide and 31% amiodarone patients (OR: 0. 49; 95% CI: 0. 15-1. 61; P: 0. 24). Among 49 patients with structural heart disease, the primary endpoint was less common in procainamide patients (3 [11%] vs. 10 [43%]; OR: 0. 17; 95% CI: 0. 04-0 V体育安卓版. 73, P = 0. 017). .

Conclusions: This study compares for the first time in a randomized design intravenous procainamide and amiodarone for the treatment of the acute episode of sustained monomorphic well-tolerated (probably) ventricular tachycardia. Procainamide therapy was associated with less major cardiac adverse events and a higher proportion of tachycardia termination within 40 min V体育ios版. .

Keywords: Acute treatment; Amiodarone; Procainamide; Ventricular tachycardia VSports最新版本. .

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Figures

Figure 1
Figure 1
Summary of patient recruitment and results.
Figure 2
Figure 2
Odds ratio and confidence intervals of adverse events and tachycardia termination of procainamide patients compared with amiodarone patients. AE, adverse events; MCAE, major cardiac adverse events; SP, study period (40 min); OP, observation period (24 h).
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Comment in

  • A dolus of i.v. amiodarone.
    Finlay MC, Specterman M, Schilling RJ. Finlay MC, et al. Eur Heart J. 2017 May 1;38(17):1336-1338. doi: 10.1093/eurheartj/ehw327. Eur Heart J. 2017. PMID: 27469374 No abstract available.

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