Does intravenous lignocaine suppress ventricular ectopic activity and improve clinical outcomes in patients after acute myocardial infarction?
Routine use of intravenous lignocaine for ventricular ectopic activity after acute myocardial infarction is not supported, as it does not reduce the incidence of ventricular tachycardia, fibrillation, or mortality.
The effectiveness of intravenous lignocaine in suppressing ventricular ectopic activity after acute myocardial infarction was examined in a double-blind trial in 82 patients. Whereas suppression of unifocal ventricular ectopics was achieved by lignocaine in 90% of patients, other forms of potentially more dangerous ectopic activity (multifocal or R-on-T ectopics) seemed more resistant to therapy. Cessation of ectopic activity was also observed in about one-third of the patients in the control group. The incidence of ventricular tachycardia and fibrillation and the mortality during and after the trial period were similar in the lignocaine-treated and control groups, whether or not the initial ventricular ectopics had been suppressed.This study provides no evidence to support the routine use of intravenous lignocaine in the management of ventricular ectopic activity after acute myocardial infarction.
Chopra et al. (1971) studied this question.