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To the Editor:—
The article, "Large Doses of Procainamide for Paroxysmal Ventricular Tachycardia," which appeared in The Journal (209:1221, 1929), described four cases of recurrent ventricular tachycardia controlled by procainamide in doses up to 10.5 gm daily. Long-term follow-up of these patients is not given, and the authors state that the dosage can usually be decreased after several weeks of therapy.About four years ago, I reported a similar observation.1 A patient with coronary heart disease and recurrent ventricular tachycardia required 10.5 gm of procainamide daily to prevent recurrence. This dose was continued for three years, and was subsequently reduced to 8.0 gm daily. Any further reduction precipitated recurrent arrhythmia. Up to the present time, this patient has taken the large doses of the drug for seven years, without evidence of lupus erythematosus or other toxic condition.
Douglas AH. Control of Tachycardia By Procainamide. JAMA. 1969;210(4):728. doi:10.1001/jama.1969.03160300068027