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Lidocaine-induced second-degree mobitz type II heart block
Drug Intelligence & Clinical Pharmacy
|September 1, 1985
Summary
Lidocaine can unpredictably cause severe atrioventricular (AV) block, even at therapeutic doses. This rare but serious side effect necessitates careful patient selection and monitoring when administering lidocaine.
Area of Science:
- Cardiology
- Clinical Electrophysiology
- Pharmacology
Background:
- Lidocaine is commonly used as a local anesthetic and antiarrhythmic drug.
- Its effects on atrioventricular (AV) conduction are generally considered minimal at therapeutic doses in patients with normal AV conduction.
- However, sporadic reports suggest potential adverse effects on cardiac conduction.
Observation:
- Electrophysiological studies on lidocaine's impact on AV conduction have yielded conflicting results.
- Previous case reports have described accelerated AV conduction or complete heart block following lidocaine administration.
- One reported case involved Mobitz type II heart block in a patient with a prolonged QTc interval and concurrent prenylamine use.
Findings:
- This study presents a case of Mobitz type II heart block occurring after therapeutic lidocaine doses.
- The patient had no acute myocardial infarction or concurrent administration of other cardioactive drugs.
- This case highlights the unpredictable nature of lidocaine-induced AV block.
Implications:
- Lidocaine-induced atrioventricular block, while infrequent, can be severe.
- The unpredictable occurrence of these reactions underscores the need for careful patient selection.
- Close monitoring of patients receiving lidocaine is crucial to detect and manage potential conduction disturbances.