Calif Med. 1952 Jun;76(6):370-5.
California medicine
M H Nathanson, H Miller
PMID: 18731818 PMCID: PMC1521307
The syncopal attacks of complete heart block may be due either to ventricular standstill or to ventricular acceleration including fibrillation. As treatment may be harmful unless the underlying mechanism in each case is determined, it is important to apply the available methods for differentiation. Epinephrine and certain related compounds (sympathomimetic amines) are the only effective substances in the therapy of ventricular arrest. Isopropyl nor-epinephrine is a most potent drug in the prevention and treatment of ventricular arrest and has the advantage that it does not dispose to fibrillation. Quinidine is unreliable and probably hazardous in the control of ventricular fibrillation in heart block as it appears to precipitate this arrhythmia.Preliminary observations indicate that ectopic ventricular rhythms are also induced by procaine amide in complete heart block.Isuprel(R) may be of value in the therapy of ventricular acceleration, by preventing the ventricular arrest which frequently follows the initial acceleration.
