Document Detail


Profibrillatory effects of lidocaine in the acutely ischemic porcine heart.
MedLine Citation:
PMID:  7630159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Because recent clinical studies have failed to show evidence of the benefit of lidocaine in the arrhythmias occurring in the early stage of myocardial infarction and have even shown an increased mortality in patients thus treated, we investigated the value of lidocaine as a protective agent against ventricular fibrillation related to myocardial ischemia in the in situ heart of anesthetized open-chest pigs subjected to transient total occlusion of the proximal left anterior descending coronary artery (LAD) under ventricular pacing at a constant high rate. Vulnerability to the fibrillatory process induced by coronary occlusion was assessed both by time to onset of ventricular fibrillation (TF) and by electrical ventricular fibrillation threshold (EFT) determined after coronary occlusions of increasing duration (30, 60, 120, 180 s). Monophasic action potential (MAP) was recorded concurrently in the nonischemic and ischemic areas. Lidocaine, even in relatively high doses (2-4 mg.kg-1), did not prolong TF, nor did it increase EFT. On the contrary, TF was significantly shortened and EFT was significantly decreased (15-30%) at the maximal concentrations of lidocaine, with return to control values in 40-60 min. Therefore, lidocaine tends to increase the risk of ischemic ventricular fibrillation (VF): It fails to control the extreme enhancement of excitability and worsens conduction disorders, even though it decreases normal conduction only slightly. Use of lidocaine against rhythm disorders in acute myocardial infarction (AMI), is at least debatable and probably contraindicated.
Authors:
J F Aupetit; Q Timour; J Loufoua-Moundanga; L Barral-Cadière; M Lopez; M Freysz; G Faucon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  25     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-09-05     Completed Date:  1995-09-05     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  810-6     Citation Subset:  IM    
Affiliation:
Département de Cardiologie, Hôpital Saint Joseph-Saint Luc, Lyon, France.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials / drug effects
Animals
Cardiac Pacing, Artificial
Coronary Disease / drug therapy
Disease Models, Animal
Electrocardiography / drug effects
Electrophysiology
Female
Lidocaine / administration & dosage,  pharmacology,  therapeutic use*
Male
Myocardial Ischemia / drug therapy*
Reproducibility of Results
Swine
Ventricular Fibrillation / drug therapy*
Chemical
Reg. No./Substance:
137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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