Lidocaine in out-of-hospital ventricular fibrillation. Does it improve survival?

The use of amiodarone for in-hospital cardiac arrest at two tertiary care centres

“…The use of lidocaine is largely based on its effectiveness in preventing ventricular arrhythmias following myocardial infarction (7,8) rather than on evidence of improved patient survival (9)(10)(11). In out-of-hospital resuscitations, lidocaine did not increase the rate of successful cardioversion (12) or survival to hospital discharge (13). Thus, it is tempting to disregard our negative results as observational error and continue forward with no further examination of amiodarone resuscitation policies.…”

Part 6: Advanced Cardiovascular Life Support : Section 5: Pharmacology I: Agents for Arrhythmias

“…25 Lidocaine improved resuscitation rate and admission alive to the hospital rate in 1 retrospective prehospital study, 105 but other trials comparing lidocaine and bretylium found no statistically significant differences in outcome. 106 -108 A randomized comparison between amiodarone and lidocaine found a greater likelihood of successful resuscitation with amiodarone.…”

Antiarrhythmic Medications for Cardioversion and Maintenance of Sinus Rhythm in Patients with Cardiac Arrhythmias: A Review of the Literature

“…Weaver et al found that there was no difference in survival between patients receiving lidocaine vs. epinephrine during treatment for VF (19% vs. 20%) but survival was highest in patients who received no drug therapy (30%) possibly due to lack of delay of subsequent defibrillation shocks [38]. Herlitz et al found in a retrospective review that treatment with lidocaine was associated with a higher rate of return of spontaneous circulation but not an increased rate of discharge from the hospital [39].…”