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Controlled trial of prophylatic treatment with lidocaine in acute myocardial infarction

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Summary

The prophylactic value of lidocaine in the treatment of cardiac arrhythmias in acute myocardial infarction has been assessed quantitatively in 89 patients by continuous monitoring of the ECG. Patients with ventricular fibrillation, flutter or tachycardia on admission, with severe left heart failure or cardiogenic shock were excluded from the study. 41 of the 89 were treated with lidocaine (28:20–30 mg/kg; 13:31–60 mg/kg) and 48 controls received no antiarrhythmic treatment. Ventricular ectopic beats and runs of ventricular extrasystoles were equally common in groups receiving low and high doses of lidocaine. 7.3% of the patients treated prophylactically had ventricular tachycardias and they occurred in 10.4% of the untreated controls. Primary ventricular fibrillation caused the death of one control patient. No other difference in mortality was observed between the groups. 1st and 2nd degree AV-block was observed increasingly often in both groups during the monitoring period. The incidence of AV-block increased two-fold from the first to the third day in the lidocaine group compared with the untreated patients. It is concluded that lidocaine cannot be recommended as a general prophylatic treatment in acute myocardial infarction.

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Authors and Affiliations

  1. Department of Internal Medicine I, Rheinisch-Westfälische Technische Hochschule Aachen, Germany (FRG)

    W. Bleifeld, W. Merx, K. W. Heinrich & S. Effert

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  1. W. Bleifeld
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  2. W. Merx
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  3. K. W. Heinrich
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  4. S. Effert
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Supported by the Amt für Forschung des Landes Nordrhein-Westfalen.

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Bleifeld, W., Merx, W., Heinrich, K.W. et al. Controlled trial of prophylatic treatment with lidocaine in acute myocardial infarction. Eur J Clin Pharmacol 6, 119–126 (1973). https://doi.org/10.1007/BF00562438

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  • DOI: https://doi.org/10.1007/BF00562438

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