Topic Reviews A-Z
Lidocaine Topic Review
Lidocaine is a class IB antiarrhythmic drug used for the treatment of ventricular arrhythmias, specifically ventricular tachycardia and ventricular fibrillation.
Lidocaine blocks cardiac sodium channels shortening the action potential and is used intravenously only for arrhythmia. Lidocaine is also used as a topical anesthetic.
Lidocaine is not recommended for prophylactic administration to suppress premature ventricular contractions or prevent ventricular tachycardia (VT) or ventricular fibrillation (VF) after an acute coronary syndrome [Al-Khatib SM, et al. J Am Coll Cardiol. 2017;e120a]. Lidocaine toxicity is a concern.
The 2017 American Heart Association/American College of Cardiology/Heart Rhythm Society Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death states that intravenous lidocaine can be beneficial (Class of recommendation 2a) in patients with a witnessed cardiac arrest due to VF or polymorphic VT that is unresponsive to cardiopulmonary resuscitation, defibrillation and vasopressor therapy. [Al-Khatib SM, et al. J Am Coll Cardiol. 2017;e119a]