Although recurrent ventricular tachycardia can be controlled in many patients with standard doses of procainamide hydrochloride or quinidine sulfate, the occasional patient with a condition refractory to this therapy has been treated with beta- adrenergic blocking agents, cardiac sympathectomy, or pacemakers. In four patients with refractory ventricular tachycardia, 7.5 to 10.5 gm procainamide hydrochloride successfully controlled the arrhythmia without adverse sequelae. Physicians should consider large doses of procainamide before they utilize more radical therapy.
Patton RD, Patten E, Stein E, Damato AN. Large Doses of Procainamide for Paroxysmal Ventricular Tachycardia. JAMA. 1969;209(8):1221-1222. doi:10.1001/jama.1969.03160210053018