Procainamide vs Amiodarone for VT

PROCAMIO: Randomized Comparison of Intravenous Procainamide Vs. Intravenous Amiodarone for the Acute Treatment of Tolerated Wide QRS Tachycardia

The Bottom Line - July 29, 2016 - By David Slessor

Ref: Ortiz. European Heart Journal: Advanced Access June 2016, doi:10.1093/eurheartj/ehw230

"Clinical Question 

In patients with wide QRS (probably ventricular) tachycardia, does intravenous procainamide compared with intravenous amiodarone reduce major adverse cardiac events? 

Authors’ Conclusions 

For the treatment of the acute episode of sustained monomorphic well-tolerated wide QRS tachycardia (probably VT), procainamide therapy was associated with less major cardiac adverse events and a higher proportion of tachycardia termination within 40 min. 

The Bottom Line 

The results of this trial suggest an improved safety profile and efficacy of 10mg/kg intravenous procainamide over 20mins when compared with 5mg/kg intravenous amiodarone over 20mins in tolerated wide complex tachycardia."