Procainamide is an antiarrhythmic used to treat cardiac arrhythmias. It induces rapid block of the batrachotoxin (BTX)-activated sodium channels of the heart muscle and acts as antagonist to long gating closures. Procainamide is metabolized via different pathways. The most common one is the acetylation of procainamide to the less toxic N- acetylprocainamide. Procainamide was approved by the US FDA on June 2, 1950.