Can Lidocaine Be Used for Heart Arrhythmias?

Heart Arrhythmias

Can Lidocaine Be Used for Heart Arrhythmias?

When defibrillation is ineffective at treating cardiac arrest brought on by a ventricular arrhythmia, lidocaine is administered intravenously. It might increase the likelihood of survival.

Your heart beating abnormally or with an aberrant rhythm is known as cardiac arrhythmia. It's estimated that up to 5% of Americans suffer from cardiac arrhythmia.

While many arrhythmias are not dangerous, a few of them can stop your heart from pumping. To treat persons whose hearts have stopped beating as a result of ventricular arrhythmia and who do not react to defibrillation, the drug lidocaine is frequently delivered intravenously (via an IV).

In this article, we examine the application of lidocaine for the treatment of heart arrhythmias.

What types of cardiac arrhythmias are treated with lidocaine?

A ventricular arrhythmia can cause cardiac arrest, which is treated with lidocaine. When your heart stops beating suddenly, you are in cardiac arrest. Cardiovascular arrest is frequently caused by ventricular fibrillation.

The two primary varieties of ventricular arrhythmias are:
  • Ventricular tachycardia is characterized by an unusually rapid heartbeat of 100 beats per minute (bpm) for a period of more than three heartbeats.
  • Ventricular fibrillation: This arrhythmia is regarded as being the most dangerous. It occurs when your heart's lower chambers start to beat abnormally rather than properly. This prevents your heart from pumping vigorously enough to circulate blood throughout your body.

What is lidocaine?

A drug called lidocaine is employed as an anaesthetic. Before surgery, doctors frequently inject lidocaine into the skin to relieve discomfort. Pain from minor wounds like scrapes or insect bites may be treated with lidocaine lotion.

Ventricular arrhythmia can also be treated with lidocaine. An IV is used to give lidocaine for the treatment of ventricular arrhythmia.

An initial dose of 1.0 to 1.5 milligrams of lidocaine per kilogram of body weight and a second dose of 0.5 to 0.75 milligrams of lidocaine per kilogram, if necessary, are advised for the treatment of ventricular arrhythmia.

Why isn't lidocaine used to treat atrial tachycardias?

For the most part, lidocaine is unsuccessful in treating vascular arrhythmia. It might have issues with ventricular activity if used to treat arterial arrhythmia.

Does lidocaine have side effects?

Lidocaine rarely causes toxicity and is often harmless. It occasionally has negative effects that could be fatal.

When lidocaine is used to treat an arrhythmia, the following side effects are possible:
  • insomnia
  • seizure
  • drowsiness, confusion
  • light-headedness
  • euphoria
  • slurred speech
  • psychosis
  • tremors
  • changes in consciousness
  • tinnitus
  • personality changes
  • low blood pressure
  • breathing problems

Older folks, those who have heart failure, and those who have severe liver dysfunction may have side effects more frequently.

What further drugs are available to treat ventricular arrhythmias?

Ventricular arrhythmias can be prevented or treated using a variety of drugs. They can be grouped generally into the following groups:
  • Potassium channel blockers predominate Amiodaron, and sotalol, Similar to how lidocaine is employed, amiodarone does too. If amiodarone is ineffective for treating premature ventricular contraction, sotalol is the next line of treatment.
  • Sodium channel blockers predominate: Quinidine with lidocaine, For a very long period, these drugs have been used to stop sudden death brought on by ventricular arrhythmias.
  • Blockers of calcium channels: Verapamil diltiazem, Verapamil diltiazem is typically not used to treat other types of arrhythmia, however, it may be beneficial in treating fascicular ventricular arrhythmia.
  • Drugs that alter autonomic system receptors: Beta-blockers, adenosine,  One of the first-line treatments for ventricular arrhythmia in persons with coronary heart disease is beta-blockers.
  • Blockers of cyclic nucleotide-gated channels that are hyperpolarization-activated: Ivabradine, It is being investigated whether ivabradine can lessen ventricular arrhythmia. The development of ResearchTrusted Source is just beginning.
Procainamide with amiodarone information
Researchers observed no discernible difference in outcomes between patients with ventricular arrhythmias treated with lidocaine or amiodarone in a 2022 study.

Procainamide may be more successful than lidocaine at stopping abrupt ventricular tachycardia, according to some studies, while other studies indicate that procainamide recipients are less likely to survive hospitalization.

The bottom line

For the treatment of cardiac arrest brought on by ventricular arrhythmias that don't respond to defibrillation, an IV drip of lidocaine is employed. For the same goal, doctors prescribe the drug amiodarone.

Lidocaine is used in urgent situations to increase the likelihood of survival. Lidocaine is not recommended by doctors for prolonged use.