Lidocaine-induced cardiac asystole

Area of Science:

• Cardiology
• Pharmacology

Background:

• Lidocaine is a common local anesthetic and antiarrhythmic drug.
• Cardiac electrophysiology is crucial for understanding drug effects on heart rhythm.

Observation:

• A 67-year-old man received a 50-mg intravenous bolus of lidocaine.
• The patient exhibited profound depression of pacemaker activity in the sinoatrial and atrioventricular nodes.
• No pre-existing conditions were identified that would predispose the patient to bradyarrhythmias.

Findings:

• Lidocaine administration led to significant bradyarrhythmias.
• The observed cardiac event was likely an idiosyncratic reaction to lidocaine.
• This case highlights a rare adverse effect of lidocaine on cardiac pacemakers.

Implications:

• Clinicians should be aware of potential idiosyncratic reactions to lidocaine.
• Unexplained bradyarrhythmias following lidocaine administration warrant careful evaluation.
• This case contributes to understanding the spectrum of lidocaine's cardiovascular effects.