Does intravenous sodium lactate cause ventricular arrhythmias in patients with heart block?
Intravenous sodium lactate is hazardous in patients with heart block due to a high risk of inducing ventricular tachycardia, whereas isopropylnorepinephrine is safer and more effective.
Molar sodium lactate has been described as a safe and effective agent in the treatment of bradycardia accompanying complete heart block. However, in 12 patients with heart block, hypertonic lactate infusions produced ventricular tachycardia in 6 and an increased idioventricular rate in only 4. Isopropylnorepinephrine was more effective and without such hazard. The effects of alkalosis from molar lactate, 5 per cent sodium bicarbonate, and hyperventilation are compared. Of these 3, lactate was productive of the greatest ventricular acceleration.
Murray et al. (Mon,) studied this question.