Lidocaine-induced conduction disturbance in patients with systemic hyperkalemia.
We report 2 cases in which lidocaine, given for wide-complex tachycardia in the presence of hyperkalemia, precipitated profound conduction disturbance and asystole. The electrophysiologic effects of hyperkalemia and its interaction with lidocaine are reviewed. In patients with known hyperkalemia and wide-complex tachycardia, treatment should be directed at hyperkalemia, rather than following treatment algorithms for wide-complex tachycardia.
McLean
S A
SA
Department of Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. samclean@massmed.org
Paul
I D
ID
Spector
P S
PS
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000517:prevention & control; D006329:Heart Conduction System / Q000187:drug effects; D006801:Humans; D006947:Hyperkalemia / Q000150:complications* / Q000175:diagnosis; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D013610:Tachycardia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine