An undocumented effect of lidocaine revealed by computerized electrocardiography

The influence of an intravenous push of lidocaine 1 mg/kg followed by 2 mg/min infusion on total QRS amplitude and R-to-S duration in leads V2-V4 of the electrocardiogram was studied in 11 patients who were hospitalized in the coronary care unit. A computerized system sampled the amplitude and timing of peak R and S waves of 1100 QRS complexes of leads V2-V4, starting two minutes before the first push of lidocaine. Curves of amplitude and R-to-S duration versus time were obtained in all patients. QRS amplitude in V2 and V3 increased significantly in 10 of 11 patients (p < 0.005). The mean voltage increase for all patients was 0.1 +/- 0.07 millivolt. The authors also observed a mild prolongation of R-to-S duration (0.8 +/- 1.0 millisecond p < 0.02). This new finding, obtained by a simple computerized system, may possibly have potential future practical clinical application as a feedback parameter for closed-loop control systems for the administration of lidocaine.