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  • Title: Life-threatening arrhythmias after intravenous lidocaine alone or with magnesium in myocardial infarction complicated by ventricular fibrillation.
    Author: Leone A, Mori L, Bertanelli F, Fabiano P.
    Journal: Singapore Med J; 1991 Jun; 32(3):169-70. PubMed ID: 1876891.
    Abstract:
    To compare the effects of Lidocaine (LID) alone or with Magnesium Sulfate (M) on life-threatening ventricular arrhythmias which followed cardioverted prolonged ventricular fibrillation (VF) during an acute myocardial infarction (AMI), we studied 34 (24.63%) out of 138 patients aged from 52 to 83 years (mean: 66.92 + 8.82) with an anterior AMI, who had cardioverted prolonged VF. Twenty patients (58.8%)--Group A--received LID 2 mg/min at constant-rate infusion through a subclavian catheter following a bolus of LID 100 mg, whereas 14 patients (14.2%)--Group B--received LID at the same dose + M 2.5 mg/min. All the patients had continuous monitoring and LID serum level was measured daily by means of immunofluorescent method (TDX Abbot; range 1.5-5 micrograms/ml). Group A had the following mean serum levels of LID; 250 + 0.9; 1.52; 245 +/- 0.9; 3.20 + 1.1. Group B showed: 2.65 + 1.2; 2.80 + 1.8; 3.10 + 1.2; 3.25 + 1.1. Continuous monitoring displayed the following arrhythmias respectively for Group A and Group B: VT 37 times vs 16(P less than 0.05, significant), transiently cardioverted VF during therapy 17 times vs 6(p less than 0.01, significant), 8 deaths from VF vs 6 - 3 from VF and 3 from asystole - (p = NS). LID + M treatment seemed to be more effective than LID alone to reduce life-threatening arrhythmias following cardioverted prolonged VF of AMI but not the deaths. In addition, M would raise moderately LID serum level and this fact, not yet well known, needs further investigation.
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