Topic Reviews A-Z
Procainamide Topic Review
Procainamide is a class I antiarrhythmic drug used for the treatment of atrial fibrillation (AF).
The 2023 American College of Cardiology/American Heart Association/American College of Clinical Pharmacy/Heart Rhythm Society Guideline for the Diagnosis and Management of Atrial Fibrillation states procainamide may be considered for pharmacological cardioversion (Class 2b recommendation) in patients with AF when other intravenous agents are contraindicated or not preferred, and that it is less effective for pharmacological cardioversion than ibutilide [Joglar JA, et al. J Am Coll Cardiol. 2023;82a].
This is the drug of choice in the setting of Wolff-Parkinson-White syndrome with AF.
Procainamide can cause drug-induced systemic lupus erythematosus (SLE). Anti-histone antibodies are present in about 95% of these cases. Other medications known to cause drug-induced SLE include hydralazine, which is used to treat hypertension, and isoniazid, which is used to treat tuberculosis.