Re-entrant ventricular arrhythmias in the late myocardial infarction period. 4. Mechanism of action of lidocaine.

Abstract

SUMMARY The effect of lidocaine on re-entrant ventricular arrhythmias (RVA) was studied in dogs 3-7 days following ligation of the anterior descending coronary artery; direct recordings were made of the re-entrant pathway (RP) from the epicardial surface of the infarction zone (IZ). Lidocaine in a therapeutic dose consistently prolonged refractoriness of potentially RP(s) in the IZ and produced a higher degree of conduction block at a constant heart rate. Conduction in the adjacent normal zone was not affected.

Voltage‐ and Time‐dependent Depression of Maximum Rate of Depolarization of Guinea‐pig Ventricular Action Potentials by Two Steroidal Antiarrhythmic Drugs, Cci 22277 and Org 6001

“…Furthermore this effect is independent of rate. As partial depolarization is a well-known feature of myocardial ischaemia (see Janse & Kleber, 1981, for review), such a selective effect, already demonstrated for lignocaine (Kupersmith, Antman & Hoffman, 1975;El-Sherif, Scherlag & Lazzara, 1977), could well be of considerable clinical relevance. Finally, it should be noted that any effect on refractoriness due to this shift in the V,,-membrane potential relationship would only be minor, since membrane voltage is changing very rapidly with time during the terminal phase of the action potential.…”

Electrophysiology of coronary reperfusion. A mechanism for reperfusion arrhythmias.

“…However, subsequently several different groups of investigators have studied the effects of acute ischemia on local electrophysiology with the use of bipolar electrodes (11)(12)(13)(14)(15)(16)(17)33). (36).…”

Effect of lidocaine in acute ischemic situations: A computer modelling study

“…Carsson has proposed that the failure in the propagation can favour a unidirectional block of wave front of the stimuli [4,5].…”