Lidocaine prophylaxis for fatal ventricular arrhythmias after acute myocardial infarction*

Abstract

A 40-hour age- and weight-adjusted lidocaine infusion administered after an initial 8-hour infusion provoked more congestive heart failure than placebo. In view of the absence of ventricular fibrillation episodes with both infusions, caution should be used when lidocaine is administered for longer than 8 hours in patients with uncomplicated myocardial infarction.

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).…”

Intravenous Lidocaine and Mexiletine in the Management of Trigeminal Autonomic Cephalalgias

“…Clinical trials, however, demonstrated increased mortality and risk of congestive heart failure with the prophylactic use of class 1 antiarrhythmics, including lidocaine, to treat non-life-threatening ectopy after a myocardial infarction [9][10][11][12]. No class of antiarrhythmic drugs has been proven to reduce mortality in atrial fibrillation [13], and class 1B agents should be reserved for severe, life-threatening arrhythmias [14].…”

Synthesis and Antiarrhythmic Activity of 2-Diethylamino-2′,6′-Dimethylphenylacetamide Derivatives

“…It was found that the prophylactic administration of lidocaine in patients with myocardial infarction decreases their survival rate [3]. This outcome can be explained to a considerable extent by the difficulty of maintaining a constant therapeutic drug concentration in the blood: deviation from this level is a prerequisite of the electrical instability of myocardium [4,5].…”