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Chest, Vol 76, 699-701, Copyright © 1979 by American College of Chest Physicians

ARTICLES

Procainamide-induced sinus node dysfunction in patients with chronic renal failure

HG Kim and HS Friedman

Two patients with chronic renal failure developed transient sinus node dysfunction requiring insertion of a temporary pacemaker while receiving procainamide to control ventricular arrhythmias. Blood levels of procainamide were found to be elevated, although at these levels, sinus node dysfunction has not previously been reported. Following discontinuance of procainamide, sinus rhythm returned. A combination of factors, including elevated levels of N-acetyl procainamide, the metabolite of procainamide with anti-arrhythmic properties, are suggested as possible contributory causes for the ECG findings. Thus, procainamide may produce electrophysiologic features of "sick sinus syndrome" in patients with chronic renal failure even when blood levels of this substance are being monitored.




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Copyright © 1979 by the American College of Chest Physicians.