Effects of N-acetylprocainamide and recainam in the pharmacologic conversion and suppression of experimental canine atrial flutter: significance of changes in refractoriness and conduction.

Abstract	The electrophysiologic determinants of the pharmacologic conversion and the prevention of atrial flutter are poorly defined. This study investigated the effects of pharmacologically induced changes in atrial conduction velocity and refractoriness, in the conversion and suppression of atrial flutter induced in the open-chest anesthetized dog by intercaval crush and rapid atrial pacing. The effects of an intravenous infusion of the new class III antiarrhythmic drug N-acetylprocainamide (30 mg/kg over 15 min) and the class Ic antiarrhythmic drug recainam (10 mg/kg over 20 min followed by 10 mg/kg/h) were evaluated. N-acetylprocainamide restored sinus rhythm in 10 of 15 (66%) dogs, while recainam converted only 2 of 10 (20%). N-acetylprocainamide prevented reinduction in 3 (20%), while recainam was effective in none. In the atria, N-acetylprocainamide induced significant increases in effective refractory period (+27%, p less than 0.01), functional refractory period (+22%, p less than 0.01), and in atrial flutter cycle length (+13%, p less than 0.01). Recainam increased effective refractory period (+28%, p less than 0.01), functional refractory period (+20%, p less than 0.01), conduction time at atrial paced cycle length of 150 msec (+70%, p less than 0.01) and atrial flutter cycle length (+56%, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors	G K Feld, N Venkatesh, B N Singh
Journal	Journal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 11 Issue 5 Pg. 573-80 (May 1988) ISSN: 0160-2446 [Print] United States
PMID	2455844 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
Chemical References	Anti-Arrhythmia Agents Phenylurea Compounds recainam Acecainide Procainamide
Topics	Acecainide (therapeutic use) Anesthesia Animals Anti-Arrhythmia Agents (therapeutic use) Atrial Flutter (drug therapy, physiopathology) Dogs Electrocardiography Electrophysiology Heart Conduction System (drug effects) Phenylurea Compounds (therapeutic use) Procainamide (analogs & derivatives)

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