Effectiveness and safety of lidocaine use (review)

Abstract

Cardiac arrhythmias are complications of many cardiovascular diseases. They quite often acquire an unpredictable course and can result in the death. According to epidemiology data, heart rhythm disorders lead to the sudden death of about 200 thousand people in the Russian Federation annually. Sudden cardiac death overtakes about 400 thousand outpatients and hospital patients in the USA and about 280 thousand patients in Europe. The unpredictability of the occurrence and the transience of cardiac arrhythmias require urgent measures, including both non-pharmacological (electrical pacing, electrical shock therapy) and pharmacotherapeutic methods of treatment. This review is devoted to the study of the clinical features of the lidocaine infusions in patients with ventricular arrhythmias caused by an increase of the conducting cardiomyocytes automatism. The article presents the results of comparative effectiveness and safety studies of lidocaine prescribed for the treatment of ventricular tachycardia and ventricular fibrillation (in the absence of the effect of electro-impulse therapy). Lidocaine is compared with other antiarrhythmic drugs such as amiodarone, sotalol, bretylium tosylate and procainamide. Recommendations of ILCOR (International Committee for Interaction in the Field of Resuscitation), AHA (American Cardiology Association), ECS (European Cardiology Society) and European Society for Resuscitation for the treatment of refractory forms of ventricular arrhythmias and ventricular fibrillation are also discussed.