Related Experiment Video
Updated: Feb 9, 2026

In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Lidocaine toxicity in the setting of HeartMate II left ventricular assist device
R K Tunney1,2, K Whyte1,3, H J DeAntonio1
1East Carolina Heart Institute at ECU, Greenville, NC, USA.
What Is Known And Objective:
Lidocaine infused at 1-4 mg/min is an appropriate treatment modality for hemodynamically stable ventricular tachycardia (VT) with normal hepatic function. A case of acute lidocaine toxicity in the setting of left ventricular assist device (LVAD) is reported.
Case Summary:
A 71-year-old with a HeartMate II LVAD on chronic mexiletine and normal liver function presented with ventricular tachycardia requiring systemic lidocaine and subsequently developed altered mental status with tremors. A lidocaine level obtained within 24 hours of infusion initiation was 7.9 mcg/mL.
What Is New And Conclusion:
This case highlights the potential for marked deviation from published pharmacokinetic parameters for a narrow therapeutic window agent with concurrent LVAD.
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