Lidocaine and the quarternary ammonium compound QX-572 in acute myocardial infarction. A comparative study.
Patients with suspected or proven acute myocardial infarction complicated by ventricular arrhythmias not corrected by lidocaine therapy (bolus dose 100 mg followed by infusion 2 mg/min) were treated either with an increased dose of lidocaine (bolus dose 50 mg followed by infusion 3 mg/min) or with 600 mg N,N-bis dimethylammonium chloride (QX-572, Astra, Sweden) as an i.v. infusion during 30 min (3 patients) or 60 min (13 patients). In the lidocaine group the arrhythmias were controlled in 6 out of 15 patients, in the QZ-572 group in 12 out of 16, a difference that is not statistically significant. However, the frequency of side-effects was significantly higher (p less than 0.001) in the QX-572 group (15 out of 16 patients). They were also more severe, including pronounced tachycardia and hypertension. It is concluded that despite the high antiarrhythmic effect of QX-572, an increase of the lidocaine dose would be safer and preferable in the clinical situation studied.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D000644:Quaternary Ammonium Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000889:Anti-Arrhythmia Agents; D000644:Quaternary Ammonium Compounds; D008012:Lidocaine; C006110:carcainium chloride