Comparison of procainamide and lidocaine in terminating sustained monomorphic ventricular tachycardia

Gorgels, Anton P.M.; Dool, Adri van den; Hofs, Anton; Mulleneers, R.G.A.; Smeets, Joep L.R.M.; Vos, Marc A.; Wellens, Hein J.J.

doi:10.1016/s0002-9149(96)00224-x

Cited by 157 publications

(93 citation statements)

References 16 publications

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“…However, previous reports indicated that the efficacy of lidocaine in terminating VT was low, at only 8-19%. [8][9][10] In the present study, intravenous administration of nifekalant successfully terminated VT/VF at around 50% and prevented the recurrence of refractory VT/VF at about 60%. Most of the patients for whom nifekalant was effective in the current study were refractory to lidocaine or other antiarrhythmic drugs, however the present study was not randomized and it was done in a limited situation as described above.…”

Section: Anti-arrhythmic Efficacysupporting

confidence: 55%

“…It is possible that nifekalant enhanced the defibrillating effect of DC current by lowering the defibrillation threshold of myocardium. 10 Most class III anti-arrhythmic agents might have this kind of effect. Some experimental studies have proven the contribution of potassium channelblocking effects of these agents in lowering the defibrillation threshold.…”

Section: Defibrillation-enhancing Effectmentioning

confidence: 99%

See 1 more Smart Citation

Emergency Treatment With Nifekalant, a Novel Class III Anti-Arrhythmic Agent, for Life-Threatening Refractory Ventricular Tachyarrhythmias Post-Marketing Special Investigation

Katoh

Mitamura²,

Matsuda

et al. 2005

Circ J

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Section: Anti-arrhythmic Efficacysupporting

confidence: 55%

Section: Defibrillation-enhancing Effectmentioning

confidence: 99%

Emergency Treatment With Nifekalant, a Novel Class III Anti-Arrhythmic Agent, for Life-Threatening Refractory Ventricular Tachyarrhythmias Post-Marketing Special Investigation

Katoh

Mitamura²,

Matsuda

et al. 2005

Circ J

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“…2 In the only other prospective trial of medical treatment of spontaneous stable VT, hypotension was observed in two of 27 (7.4%) cases treated with lidocaine and one of 28 (3.6%) treated with procainamide. 65 Despite the descriptive term ''stable,'' patients with this condition often have profound underlying cardiac illness. In a retrospective study of spontaneous sustained stable VT, the mortality associated with current treatment regimens was two of 40 (5%).…”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis of the Risk of Torsades de Pointes in Patients Treated with Intravenous Racemic Sotalol

Marill

Runge

2001

Academic Emergency Medicine

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Abstract. Objective: Intravenous (IV) racemic sotalol is useful for the treatment of multiple tachydysrhythmias. The authors hypothesized that the risk of torsades de pointes (TdP) in patients treated with a single IV infusion of sotalol is lower than the 2-4% risk associated with chronic oral sotalol therapy. Methods: A MEDLINE search under the subject heading ''sotalol'' was made of all publications involving humans written in English or German from 1966 to October 1, 2000. A meta-analysis of all original reports including patients who were given a single infusion of at least 1.5 mg/kg or 100 mg of IV sotalol over 30 minutes or less was performed. Potential variables predictive of TdP were assessed. The primary outcome was the observation of TdP associated with IV sotalol infusion. Secondary measurements included hypotension, bradycardia, and worsening of congestive heart failure. All excluded studies and case reports were also examined for evidence of TdP associated with IV sotalol treatment. Results: The search included 1,005 publications. There were 37 reports in which 962 patients received IV sotalol and met the inclusion criteria. There was one report of self-terminating TdP lasting 10 seconds among the 962 patients included in the study. There was no report of TdP associated with only IV racemic sotalol administration in any of the excluded studies. If it is assumed that the risk of TdP is homogeneous in the population of patients treated with IV sotalol, then based on the 962 included patients, the rate of TdP is 0.1% (95% CI = 0.003% to 0.6%). Conclusions: The overall risk of TdP in patients treated with a single infusion of IV sotalol is low compared with that in patients given chronic oral sotalol therapy.

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“…25 But the prophylactic use of lidocaine to prevent the arrhythmias in the first place causes higher mortality and has been abandoned. 26 -29 Two studies suggest that lidocaine is ineffective for termination of hemodynamically stable sustained VT, 30,31 and 2 have found lidocaine to be less effective against VT than IV procainamide 32 or IV sotalol. 33 In summary, lidocaine appears in the algorithm for stable VT, monomorphic or polymorphic (in Part 6, Section 7D).…”

Section: Lidocainementioning

confidence: 99%

“…The Stable Ventricular Tachycardia Algorithm shows how the specific choice of agent is based on considerations of normal versus impaired cardiac function and long versus short QT intervals. Although lidocaine can be administered rapidly with minimal effect on blood pressure, studies suggest that it is relatively ineffective for termination of VT 30,31 and less effective against VT than IV procainamide 32 or IV sotalol. 33 Twelve studies have evaluated amiodarone for the treatment of hemodynamically unstable VT and VF.…”

Section: Hemodynamically Stable (Monomorphic) Vt (See Algorithm)mentioning

confidence: 99%

Part 6: Advanced Cardiovascular Life Support : Section 5: Pharmacology I: Agents for Arrhythmias

2000

Circulation

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Comparison of procainamide and lidocaine in terminating sustained monomorphic ventricular tachycardia

Cited by 157 publications

References 16 publications

Emergency Treatment With Nifekalant, a Novel Class III Anti-Arrhythmic Agent, for Life-Threatening Refractory Ventricular Tachyarrhythmias Post-Marketing Special Investigation

Emergency Treatment With Nifekalant, a Novel Class III Anti-Arrhythmic Agent, for Life-Threatening Refractory Ventricular Tachyarrhythmias Post-Marketing Special Investigation

Meta‐analysis of the Risk of Torsades de Pointes in Patients Treated with Intravenous Racemic Sotalol

Part 6: Advanced Cardiovascular Life Support : Section 5: Pharmacology I: Agents for Arrhythmias

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