Key result
Lidocaine regains focus for treating acute sustained ventricular tachyarrhythmias despite amiodarone and modern device therapy.
Why the study?
Although lidocaine use declined with amiodarone and device therapy, it has recently regained attention for treating acute sustained ventricular tachyarrhythmias.
Lidocaine, a class Ib anti-arrhythmic, has recently come back into focus for the treatment of acute sustained ventricular tachyarrhythmias.
Answers are grounded in this paper and cite their sources.
Lidocaine may merit re-evaluation for refractory VT; leaves open need for modern RCTs versus amiodarone.
Lidocaine is classified as a class Ib anti-arrhythmic that blocks voltage- and pH-dependent sodium channels. It exhibits well investigated anti-arrhythmic effects and has been the anti-arrhythmic of choice for the treatment of ventricular arrhythmias for several decades. Lidocaine binds primarily to inactivated sodium channels, decreases the action potential duration, and increases the refractory period. It increases the ventricular fibrillatory threshold and can interrupt life-threatening tachycardias caused by re-entrant mechanisms, especially in ischemic tissue. Its use was pushed into the background in the era of amiodarone and modern electric device therapy. Recently, lidocaine has come back into focus for the treatment of acute sustained ventricular tachyarrhythmias. In this brief overview, we review the clinical pharmacology including possible side effects, the historical course, possible indications, and current Guideline recommendations for the use of lidocaine.
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Güler et al. (2023) conducted a review in Ventricular arrhythmias. Lidocaine was evaluated. Lidocaine has come back into focus for the treatment of acute sustained ventricular tachyarrhythmias, despite its use being pushed into the background by amiodarone and modern electric device therapy.
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