The effects of lidocaine on the electrical and mechanical activity of the heart

Lieberman, Norman A.; Harris, RC; Katz, Robert I.; Lipschutz, Herbert M.; Dolgin, Martin; Fisher, Vincent J.

doi:10.1016/0002-9149(68)90122-7

Cited by 85 publications

(15 citation statements)

References 9 publications

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“…For instance, lidocaine, at therapeutic levels, seems to have less effect on excitability and intraventricular conduction than procaine amide or quinidine (14). Lidocaine is more effective against arrhythmias induced by digitalis (7,(15)(16)(17) and less effective against atrial arrhythmias such as atrial fibrillation or flutter than procaine amide or quinidine (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Effect of lidocaine on the electrophysiological properties of ventricular muscle and Purkinje fibers

Jt¹,

Wj²

1970

J. Clin. Invest.

249

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A B S T R A C T Preparations of right ventricular papillary muscle and false tendon (Purkinje fiber) were obtained from dog hearts, placed in a bath perfused with Tyrode solution, and observed both under control conditions and during exposure to lidocaine in concentrations from 1 X 10-7 to 5 X 10-' mole/liter. Transmembrane voltages were recorded from both ventricular muscle (VM) and Purkinje fibers (PF) of spontaneously beating and electrically driven preparations. Low concentrations (1 X 10' and 1 X 10' mole/liter) attenuated or abolished phase 4 (diastolic) depolarization and spontaneous firing in PF without decreasing their diastolic excitability. Concentrations of 1 X 10' mole/ liter produced maximal shortening of both action potential duration (APD) and effective refractory period (ERP) and made the ERP long relative to APD; the latter alteration was more prominent in VM. At concentrations < 1 X 10' mole/liter, lidocaine either caused a slight increase or no change in peak maximum rate of phase 0 depolarization (Vrax) and membrane responsiveness, the relationship between transmembrane activation voltage (MAV)

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Section: Introductionmentioning

confidence: 99%

Effect of lidocaine on the electrophysiological properties of ventricular muscle and Purkinje fibers

Jt¹,

Wj²

1970

J. Clin. Invest.

249

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“…R osen et al [4], recording the His bundle electrocardiogram, observed the effect of a rapid intravenous injection of lidocaine (1-2 mg/kg) on atrioventricular and intraventricular conduction in pa tients with various arrhythmias and reported that lidocaine had little effect on the conduction time. L ieberman et al [3] also reported that lidocaine did not affect the intraventricular conduction time. Bekheit et al [2] investigated the effect of lidocaine on atrioventricular conduction in cases of disorder of the His-Purkinje system and they observed no significant change at therapeutic doses of Ko 1173.…”

Section: Discussionmentioning

confidence: 94%

Experimental Studies on the Antiarrhythmic Action of a Lidocaine Analog

Okuma¹,

Sugiyama²,

Wada³

et al. 1976

Cardiology

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The electrophysiologic properties of a lidocaine analog (Kö 1173) was experimentally studied in 41 mongrel dogs. The threshold for occurrence of repetitive ventricular extrasystoles was significantly raised by the administration of 2, 4, and 8 mg/kg of the drug, while atrioventricular and intraventricular conduction times were not affected. After ligation of the anterior descending branch of the left coronary artery, the threshold for occurrence of repetitive ventricular extrasystoles was significantly lowered before the administration of Kö 1173 but it returned to control values after the administration 1 mg/kg of the drug. The strength-interval curve shifted progressively to the right when the dose was increased from 2 to 4 and 8 mg/kg. These results indicate that Kö 1173 prevents the decrease in threshold for occurrence of repetitive ventricular extrasystoles in acute coronary insufficiency at a dose which does not affect the conduction system.

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“…Thus it would be unlikely that reproducible values for specialized conduction times could be obtained during prolonged studies, or in the same animal studied on two or more occasions. It follows that investigations of the effects of drugs or drug-drug interactions on atrioventricular conduction times, that cannot for ethical reasons be performed in human volunteers, have had to be performed in anesthetized dogs (2)(3)(4)(5). The lack of an unanesthetized control casts uncertainty as to the validity of results.…”

Section: Discussionmentioning

confidence: 99%

“…A preparation with the conscious state as control would be relevant, as dogs could be subjected to antiarrhythmic or other drug treatment regimes similar to those used in the clinical setting. Most studies of drug effects on electrical properties of the in situ dog heart have been performed with an intravenous anesthetic (2,3), or a light level of an inhalation agent (4,5) serving as control. Potential drug-drug interactions (2,3) and the absence of an awake control (4,5) may have confounded the meaning of results.…”

Section: Introductionmentioning

confidence: 99%

Chronic recording from the His bundle of the awake dog

1984

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The conventional catheter method for measuring specialized A-V nodal and His-ventricular conduction times in the intact dog heart precludes an unanesthetized control. This control is necessary for meaningful studies of the effect of drugs or drug-drug interactions on A-V conduction times. At right thoracotomy (halothane anesthesia), mongrel dogs had bipolar electrodes sutured to the epicardial surface of both atrial appendages, junctions of the sulcus terminalis with both vena cavae, and right ventricle. A unipolar needle electrode, referenced to a unipolar electrode on the ascending aorta, was inserted into the interatrial septum from the aortic root for recording the His bundle electrogram. After one to three weeks for stabilization, weekly measurements were made of A-V nodal conduction time (AVN) and His-ventricular conduction time (H-V) for up to 52 weeks (4 to 52 weeks). Mean values (13 dogs) for spontaneous cycle length, AVN and H-V conduction times were 477 +/- 25, 82 +/- 3, and 30 +/- 1 msec, respectively. Simultaneous recordings from catheter and implanted His bundle electrodes were made during changes in atrial paced rate (five dogs, pentobarbital anesthesia). Values for AVN and H-V conduction times from catheter or implanted electrodes were the same. AVN conduction time increased, H-V conduction time remained constant during increases in atrial rate. Atropine shortened and propranolol prolonged AVN conduction time in six unanesthetized, unsedated dogs; neither affected H-V conduction time. Histologic examination of electrode sites in two dogs at 43 and 52 weeks showed no evidence of damage to underlying myocardial recording sites. This preparation provides reproducible awake values for AVN and H-V conduction times, and hence a more meaningful control for pharmacologic investigations.

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The effects of lidocaine on the electrical and mechanical activity of the heart

Cited by 85 publications

References 9 publications

Effect of lidocaine on the electrophysiological properties of ventricular muscle and Purkinje fibers

Effect of lidocaine on the electrophysiological properties of ventricular muscle and Purkinje fibers

Experimental Studies on the Antiarrhythmic Action of a Lidocaine Analog

Chronic recording from the His bundle of the awake dog

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