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Electrophysiologic effects of lidocaine in children
Insights
Intravenous lidocaine did not significantly alter cardiac conduction times or refractory periods in children. This study confirms previous findings in adults regarding lidocaine
Area of Science:
- Cardiology
- Pharmacology
- Pediatric Electrophysiology
Background:
- Intravenous lidocaine is commonly used for cardiac arrhythmias.
- Its effects on cardiac electrophysiology, particularly in pediatric populations, require thorough investigation.
- Understanding lidocaine's impact on conduction and refractoriness is crucial for safe and effective clinical application.
Purpose of the Study:
- To evaluate the electrophysiological effects of intravenous lidocaine on the cardiac conduction system in children.
- To assess the impact of lidocaine on atrial, AV nodal, and ventricular refractory periods.
- To compare findings in pediatric patients with existing data from adult studies.
Main Methods:
- Utilized His bundle recordings and the extrastimulus technique for precise electrophysiological measurements.
- Administered lidocaine intravenously as a bolus (1 mg/Kg) followed by a continuous infusion (100 µg/Kg/min).
- Measured key intervals (AH, HV) and refractory periods (atrial, AV nodal, ventricular) before and after drug administration, with and without pacing.
Main Results:
- No significant changes were observed in atrial, AV nodal, or right ventricular refractory periods following lidocaine administration.
- AH and HV intervals, representing conduction through the AV node and His-Purkinje system, remained unchanged.
- Resting sinus cycle length was also unaffected by the intravenous lidocaine treatment.
Conclusions:
- Intravenous lidocaine, at the studied doses, does not significantly affect cardiac conduction or refractory periods in the pediatric population.
- These findings in children align with previous electrophysiological studies conducted in adult subjects.
- The study supports the current understanding of lidocaine's electrophysiological profile across different age groups.
Abstract:
The effects of intravenous lidocaine on the refractory periods of the atrium, AV node and right ventricular myocardium were studied using His bundle recordings and the extrastimulus technique with and without atrial and ventricular pacing. The drug was administered in an intravenous bolus dose of 1 mg/Kg followed by an infusion of 100 micrograms/Kg/min. The AH, HV intervals and resting sinus cycle length as well as functional and effective refractory periods of atrium, AV node and right ventricle were measured before and 5 min afrer bolus injection of lidocaine. Neither of the refractory periods nor AH and HV intervals changed significantly following administration of lidocaine. The result of this first study in children is in agreement with previous reports of the effects of lidocaine on the cardiac conduction system in adults.