Key result
IV lidocaine before IC papaverine links to a ~1.6% ventricular arrhythmia rate during coronary functional assessment.
Why the study?
Papaverine induces stable and prolonged hyperemia for coronary functional assessment but increases ventricular arrhythmia risk, with reported event rates of 1.7-5%.
Does prophylactic intravenous lidocaine before intracoronary papaverine reduce arrhythmic events in patients with chronic coronary syndrome undergoing invasive coronary functional assessment?
Observational (n=363)
No
Does prophylactic intravenous lidocaine before intracoronary papaverine reduce arrhythmic events in patients with chronic coronary syndrome undergoing invasive coronary functional assessment?
Prophylactic intravenous lidocaine before intracoronary papaverine administration is feasible and associated with a low rate (1.6%) of ventricular arrhythmias during invasive coronary functional assessment.
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May support prophylactic lidocaine to limit arrhythmias with papaverine; hypothesis-generating and requires randomized confirmation.
Vassilev et al. (2025) conducted an observational in Chronic coronary syndrome (n=363). Intravenous lidocaine followed by intracoronary papaverine was evaluated on Rate of arrhythmic events. Initial administration of intravenous lidocaine before intracoronary papaverine during invasive coronary functional assessment resulted in a ventricular arrhythmic event rate of 1.6%.
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