In this issue of the Journal, Chang et al1 present a thought-provoking, single-center retrospective analysis of 37 patients receiving either procainamide or IV amiodarone for refractory supraventricular arrhythmias (SVA), excluding junctional ectopic tachycardia (JET). They compare the relative efficacy of the drugs, finding procainamide to be fully successful in 50% of cases, whereas amiodarone was only successful for 15%, a statistically significant difference. Adverse effects were similar between the drugs. They conclude that procainamide may be a more effective treatment option and more importantly challenge the "perceived superiority and safety of amiodarone."
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