A 70-year-old male patient develops a large anterior wall myocardial infarction. He is currently being managed with oxygen, aspirin, nitrates and a beta-blocker. He develops recurrent episodes of ventricular tachycardia and remains conscious however has dizzy spells and also becomes diaphoretic and hypotensive. An IV bolus of lidocaine is given followed by IV lidocaine infusion.
• Which class of antiarrhythmics does lidocaine fall under? Lidocaine is a Class IB antiarrhythmic, fast sodium channel blockers. It can bind to both open and inactivated Na+ channels. Class Ib has a fast onset and has little or no effect on slower heart rates and more effects on faster heart rates. Also, they shorten the action potential and reduce refractoriness. …show more content…
412). Lidocaine “suppresses automaticity in the His-purkinje system and spontaneous depolarization of the ventricles during diastole”(Miller & Clements, 2011, p. 2). It acts on ischemic myocardial tissue by producing an anesthetic effect. This results in stabilization of membranes, elevated ventricular fibrillation threshold, and suppression of ventricular ectopy in tissues during myocardial …show more content…
The cause of the arrhythmias is “related to the formation of re-entry circuits at the confluence of the necrotic and viable myocardium, as well as to irritable ischemic myocardium”(Grasso & Brener, 2014, p. 1). Amiodarone is typically the first treatment initiated for ventricular arrhythmias. Lidocaine is given when arrhythmias are not responsive to amiodarone administration. This antiarrhythmic agent is thought to “block sodium channels more effectively in ischemic myocardium and it may be more effective therapy in suppressing automacity, which is believed to be the typical mechanism of dysrhythmia induction in ventricular tachycardia in the setting of myocardial infarction”(DeSouza, Martindale, & Sinert, 2015, p. 164). Subsequently, lidocaine is indicated in this patient since the ventricular tachycardia was probably the result of the myocardial infarction. When given intravenously, the lidocaine bolus moves rapidly from the blood into the heart and has an immediate onset. Continuous infusion should decrease the continuation of ventricular
• Which class of antiarrhythmics does lidocaine fall under? Lidocaine is a Class IB antiarrhythmic, fast sodium channel blockers. It can bind to both open and inactivated Na+ channels. Class Ib has a fast onset and has little or no effect on slower heart rates and more effects on faster heart rates. Also, they shorten the action potential and reduce refractoriness. …show more content…
412). Lidocaine “suppresses automaticity in the His-purkinje system and spontaneous depolarization of the ventricles during diastole”(Miller & Clements, 2011, p. 2). It acts on ischemic myocardial tissue by producing an anesthetic effect. This results in stabilization of membranes, elevated ventricular fibrillation threshold, and suppression of ventricular ectopy in tissues during myocardial …show more content…
The cause of the arrhythmias is “related to the formation of re-entry circuits at the confluence of the necrotic and viable myocardium, as well as to irritable ischemic myocardium”(Grasso & Brener, 2014, p. 1). Amiodarone is typically the first treatment initiated for ventricular arrhythmias. Lidocaine is given when arrhythmias are not responsive to amiodarone administration. This antiarrhythmic agent is thought to “block sodium channels more effectively in ischemic myocardium and it may be more effective therapy in suppressing automacity, which is believed to be the typical mechanism of dysrhythmia induction in ventricular tachycardia in the setting of myocardial infarction”(DeSouza, Martindale, & Sinert, 2015, p. 164). Subsequently, lidocaine is indicated in this patient since the ventricular tachycardia was probably the result of the myocardial infarction. When given intravenously, the lidocaine bolus moves rapidly from the blood into the heart and has an immediate onset. Continuous infusion should decrease the continuation of ventricular