| Lidocaine increases the proarrhythmic effects of monophasic but not biphasic shocks. | |
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MedLine Citation:
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PMID: 11797993 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Lidocaine increases monophasic shock defibrillation energy requirement (DER) values but does not alter biphasic shock DER values. However, the mechanism of this drug/shock waveform interaction is unknown. It may be that lidocaine increases the proarrhythmic actions of monophasic shocks but not biphasic shocks. Thus, lidocaine may increase monophasic shock DER values by increasing myocardial vulnerability to shock-induced ventricular fibrillation. METHODS AND RESULTS: Area of myocardial vulnerability (AOV), defined by a two-dimensional grid according to shock strength (y-axis) and shock coupling interval (x-axis), was assessed for biphasic shocks (n = 11) and monophasic shocks (n = 13) in intact swine hearts. Shocks were randomly delivered during right ventricular pacing at 10 shock strengths (50 to 500 V) and five coupling intervals (160 to 240 msec). AOV was defined as the number of points within the test grid that induced ventricular fibrillation. AOV, upper limit of vulnerability (ULV), and DER values were determined at baseline and during systemic infusion of lidocaine (10 mg/kg/hour). Lidocaine increased AOV, ULV, and DER values by 35%, 23%, and 36%, respectively, for monophasic shocks. However, lidocaine did not alter AOV, ULV, or DER values for biphasic shocks. CONCLUSION: Lidocaine increases the AOV to monophasic shocks, which is directly related to changes in ULV and DER values. This implies that lidocaine increases the proarrhythmic activity of monophasic shocks but not biphasic shocks. This may explain why lidocaine increases monophasic shock DER values. |
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Authors:
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J J Sims; A W Miller; M R Ujhelyi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 12 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2002-01-18 Completed Date: 2002-07-15 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1363-8 Citation Subset: IM |
Affiliation:
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University of Georgia College of Pharmacy, Medical College of Georgia, and Augusta VA Medical Center, USA. jjsims@pharmacy.wisc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Anti-Arrhythmia Agents / pharmacology* Cardiac Pacing, Artificial Electric Countershock / adverse effects, instrumentation, methods* Electrocardiography / drug effects Hemodynamics / drug effects Lidocaine / pharmacology* Sodium Channel Blockers Swine Ventricular Fibrillation / etiology* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 0/Sodium Channel Blockers; 137-58-6/Lidocaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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