Nasir N, Taylor A, Doyle T K, Pacifico A
Cardiac Electrophysiology Unit, Methodist Hospital, Houston, Texas 77030.
Am J Cardiol. 1994 Dec 15;74(12):1183-6. doi: 10.1016/0002-9149(94)90544-4.
Prospective evaluations of intravenous lidocaine as therapy for sustained monomorphic ventricular tachycardia (VT) in the absence of acute myocardial infarction are lacking. Lidocaine has been promulgated as first-line therapy in patients with VT, but studies evaluating its efficacy in the electrophysiology laboratory suggest that it has poor effects in terminating or preventing induction of VT. Thus, this study sought to evaluate the clinical effectiveness of lidocaine in 3 cohorts with induced or spontaneous VT. One hundred twenty-eight patients with stable VT, occurring either spontaneously or induced at the time of electrophysiologic study either in the baseline state or at the time of pharmacologic testing, were evaluated. The response rate to lidocaine therapy as manifested by termination of VT was the primary goal of the study. Of these patients, 10 (8%) had termination of VT after lidocaine therapy. There were no significant differences in age, ejection fraction, VT cycle length, and mean dose of lidocaine between responders and 118 nonresponders. There were no serious side effects or adverse events (death, myocardial infarction, angina, or congestive heart failure). Lidocaine, although safe, is ineffective in terminating stable VT not associated with acute myocardial infarction.
目前缺乏对静脉注射利多卡因作为无急性心肌梗死情况下持续性单形性室性心动过速（VT）治疗方法的前瞻性评估。利多卡因已被宣传为VT患者的一线治疗药物，但在电生理实验室评估其疗效的研究表明，它在终止或预防VT诱发方面效果不佳。因此，本研究旨在评估利多卡因在3组诱发性或自发性VT患者中的临床疗效。对128例稳定VT患者进行了评估，这些患者的VT要么是自发出现的，要么是在电生理研究时（无论是基线状态还是药理测试时）诱发的。以VT终止来体现的利多卡因治疗反应率是本研究的主要目标。在这些患者中，10例（8%）在利多卡因治疗后VT终止。反应者与118例无反应者在年龄、射血分数、VT周期长度和利多卡因平均剂量方面无显著差异。未出现严重副作用或不良事件（死亡、心肌梗死、心绞痛或充血性心力衰竭）。利多卡因虽然安全，但在终止与急性心肌梗死无关的稳定VT方面无效。
