What is the clinical evidence from this study?

Study design: Other. Population: Acute regional ischemia and ventricular arrhythmias. Intervention: Lidocaine. Primary outcome: Subepieardial transmembrane and DC extracellular potentials and spontaneous ventricular arrhythmias.

What question did this study set out to answer?

To determine how lidocaine influences cellular electrophysiology, electrical activation patterns, and spontaneous ventricular arrhythmias during acute regional myocardial ischemia.

September 1, 1981Circulation ResearchOpen Access

The effects of lidocaine on intracellular and extracellular potentials, activation, and ventricular arrhythmias during acute regional ischemia in the isolated porcine heart.

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Key result

Lidocaine did not prevent ventricular tachycardia during acute regional ischemia in isolated porcine hearts, but high concentrations prevented its degeneration into fibrillation.

Why the study?

Does lidocaine affect transmembrane potentials and prevent ventricular arrhythmias during acute regional ischemia in isolated porcine hearts?

Population

Isolated porcine hearts undergoing acute regional ischemia via occlusion of the left anterior descending…

Comparison

Lidocaine 1 and 5 wt/ml vs No lidocaine (implied baseline/control)

Design

Preclinical

Authors

RCR. CardinalElectrophysiology MJMichiel J. JanseElectrophysiology IEI van Eeden

Discussion

Member takes

Implication

May stabilize VT in acute porcine ischemia at high doses; hypothesis-generating and should not change clinical practice.

Key Points

To determine how lidocaine influences cellular electrophysiology, electrical activation patterns, and spontaneous ventricular arrhythmias during acute regional myocardial ischemia.
Perfused isolated porcine hearts via the Langendorff technique and subjected them to acute regional ischemia via left anterior descending coronary artery occlusion.
Administered lidocaine at concentrations of 1 and 5 µg/ml while recording subepicardial transmembrane potentials, DC extracellular potentials, and activation maps.
Lidocaine concentration-dependently accelerated and magnified ischemic reductions in action potential amplitude and ST elevation while worsening activation delay and localized conduction failure.
Lidocaine failed to prevent ventricular tachycardia onset, but the 5 µg/ml concentration completely prevented degeneration into ventricular fibrillation by halting wavefront fractionation into micro-reentrant circuits.
The anti-fibrillatory mechanism occurred by converting regions of slow conduction and unidirectional block into complete, bidirectional conduction block.

Structured PICO

Does lidocaine affect transmembrane potentials and prevent ventricular arrhythmias during acute regional ischemia in isolated porcine hearts?

Population

Isolated Langendorff-perfused porcine hearts undergoing occlusion of the left anterior descending coronary artery to study acute regional ischemia.

Intervention

Lidocaine 1 and 5 wt/ml

Comparator

No lidocaine (implied baseline/control)

Outcome

Subepicardial transmembrane and DC extracellular potentials, and spontaneous ventricular arrhythmiassurrogate

In an isolated porcine heart model of acute ischemia, high-concentration lidocaine prevents the degeneration of ventricular tachycardia into fibrillation by converting areas of slow conduction into total block.

Cite This Study

Cardinal et al. (1981) studied Acute regional ischemia and ventricular arrhythmias. Lidocaine was evaluated on Subepieardial transmembrane and DC extracellular potentials and spontaneous ventricular arrhythmias. Lidocaine did not prevent ventricular tachycardia during acute regional ischemia in isolated porcine hearts, but high concentrations prevented its degeneration into fibrillation.

synapsesocial.com/papers/6a8dd8bb50db337a287dcf80 https://doi.org/10.1161/01.res.49.3.792

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The effects of lidocaine on intracellular and extracellular potentials, activation, and ventricular arrhythmias during acute regional ischemia in the isolated porcine heart.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The effects of lidocaine on intracellular and extracellular potentials, activation, and ventricular arrhythmias during acute regional ischemia in the isolated porcine heart.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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