Procainamide Challenge for Brugada Syndrome: Establishing Diagnostic Safety and the Reassuring Prognosis of Induced Patterns

Procainamide Challenge for Brugada Syndrome: Establishing Diagnostic Safety and the Reassuring Prognosis of Induced Patterns

A large-scale registry study confirms that procainamide infusion is exceptionally safe for Brugada syndrome diagnosis, with high sensitivity and specificity. Crucially, asymptomatic patients with a procainamide-induced type 1 pattern demonstrate a very low risk of future arrhythmic events, potentially guiding more conservative management strategies.
Vernakalant Beats Procainamide for Rapid ED Cardioversion of Recent-Onset Atrial Fibrillation: Results from RAFF4

Vernakalant Beats Procainamide for Rapid ED Cardioversion of Recent-Onset Atrial Fibrillation: Results from RAFF4

The RAFF4 randomized trial found intravenous vernakalant superior to procainamide for rapid cardioversion of acute atrial fibrillation in the emergency department — higher conversion within 30 minutes, faster time to sinus rhythm, and fewer electrical cardioversions, with similar short-term safety.