Effect of Procaine Amide, Quinidine, and Ajmaline in the Wolff-Parkinson-White Syndrome

作者：Hein J.J. Wellens, DIRK DURRER · 发表于：Circulation · 年份：1974 · DOI：10.1161/01.cir.50.1.114 · 被引用次数：166 · 研究领域：Cardiac Arrhythmias and Treatments、Cardiac pacing and defibrillation studies、Atrial Fibrillation Management and Outcomes

Using the single test stimulus method, atrioventricular (A-V) conduction, ventriculo-atrial conduction, the refractory period of right atrium and right ventricle, and the mechanism of tachycardia were studied in 16 patients with the Wolff-Parkinson-White syndrome. The same studies were repeated at least four times during the hour following intra-atrial administration of 10 mg procaine amide/kg body weight (six patients), 4 mg quinidine gluconate/kg body weight (six patients), or 50 mg ajmaline (four patients). Following procaine amide the refractory period of the accessory pathway increased in all patients, with temporary complete block of the accessory pathway in four patients. There was an increase in H-V interval during antegrade conduction through the A-V node-His pathway. The effective refractory period of the A-V node showed no appreciable change. In three of four patients tachycardia could not be produced by pacing in contrast to the pacing effect found prior to procaine amide. Quinidine gluconate increased the refractory period of the accessory pathway in four patients, causing temporary complete block in two patients. The H-V interval increased in three patients. The refractory period of the A-V node showed no change in three patients, lengthened in one, and shortened in the other two. Quinidine gluconate prevented pacing-induced initiation of tachycardia in two out of four patients. Ajmaline * increased the refractory period of the accessory pathway in all four pati...