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Efficacy and safety of intravenous tocainide compared with intravenous lidocaine for acute ventricular arrhythmias immediately after cardiac surgery
Journal article   Peer reviewed

Efficacy and safety of intravenous tocainide compared with intravenous lidocaine for acute ventricular arrhythmias immediately after cardiac surgery

Joel Morganroth, Ioannis P. Panidis, Sally Harley, Jeanne Johnson, Emil Smith, Horace MacVaugh and Jamila Danielle Johnson
The American journal of cardiology, v 54(10), pp 1253-1258
1984
DOI: https://doi.org/10.1016/S0002-9149(84)80075-2
PMID: 6439023
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

In this double-blind parallel study, 99 patients with acute ventricular tachyarrhythmias after open-heart surgery were given either tocainide (50 patients) or lidocaine (49 patients) intravenously as 2 bolus injections 15 minutes apart, plus a fixed-rate infusion that started at the first bolus. If needed, a third bolus was administered and simultaneously the infusion rate was doubled. The boluses and initial infusion rate for tocainide treatment were, respectively, 250, 250 and 125 mg and 1.04 mg/min, and for lidocaine treatment, 100, 50 and 50 mg and 2.08 mg/min. When efficacy was defined as 80% or greater reduction in single ventricular premature complexes (VPCs) or complete abolition of ventricular couplets or ventricular tachycardia, no difference in efficacy between the 2 treatments was found by bedside electrocardiographic monitoring. By computer analysis of 24-hour taped electrocardiograms and a regression analysis of the proportion of patients responding favorably to treatment, it was estimated that an 80% or greater reduction of single VPCs occurred in 55% of patients during tocainide treatment and in 48% of patients during lidocaine treatment; abolition of couplets occurred in 74% and 68% of patients, respectively; and abolition of ventricular tachycardia in 87% and 73% of patients, respectively. These treatment-related differences were different (p <0.004). Adverse reactions occurred in 5 patients (10%) given tocainide (hypotension in 4; junctional rhythm in 1 patient; and nausea-vomiting in 1) and led to discontinuation of treatment in 3 patients. Adverse reactions were reported in 9 patients (18%) given lidocaine (hypotension, 4; central nervous system depression, 2; bradycardia, 2; nausea-vomiting, 1; increased frequency of VPCs, 1) and led to discontinuation of treatment in 4 patients. Thus, tocainide was at least as effective, if not more effective, than lidocaine when administered intravenously for the treatment of acute ventricular arrhythmias occurring immediately after cardiac surgery.

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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