The effects of lidocaine on the vulnerable period during ventricular fibrillation

Yong-Mei Cha, B. B. Peters, P. S. Chen

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: It was postulated that a subthreshold defibrillation shock failed to halt ventricular fibrillation because the shock itself reinitiated ventricular fibrillation by falling into the vulnerable period of the wavefronts. Whether or not the timing of the vulnerable period is determined by the ventricular fibrillation cycle length is unknown. Methods and Results: We determined the patterns of epicardial activation in ten dogs by computerized mapping techniques during unsuccessful defibrillation. Lidocaine was then given to prolong the ventricular fibrillation cycle length, and the computerized mapping studies were repeated. The results showed that lidocaine increased the ventricular fibrillation cycle length from 110 ± 13 msec to 156 ± 5 msec (P < 0.001). Among 55 episodes of unsuccessful defibrillation, the site of the earliest postshock activation occurred in the center of the mapped tissue 12 times at baseline and 14 times during lidocaine infusion. At electrodes that registered as postshock early sites, the preshock intervals clustered within a narrow range both before (58 ± 14 msec) and during (101 ± 18 msec, P < 0.001) lidocaine infusion. The correlation between the preshock intervals and the ventricular fibrillation cycle length was significant for these 26 sites (r = 0.87, P < 0.001). Conclusion: We conclude that a vulnerable period is present during ventricular fibrillation, and the timing of the vulnerable period is determined by the ventricular fibrillation cycle length.

Original languageEnglish (US)
Pages (from-to)571-580
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Volume5
Issue number7
StatePublished - 1994
Externally publishedYes

Fingerprint

Ventricular Fibrillation
Lidocaine
Shock
Electrodes
Dogs

Keywords

  • lidocaine
  • ventricular fibrillation

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

The effects of lidocaine on the vulnerable period during ventricular fibrillation. / Cha, Yong-Mei; Peters, B. B.; Chen, P. S.

In: Journal of Cardiovascular Electrophysiology, Vol. 5, No. 7, 1994, p. 571-580.

Research output: Contribution to journalArticle

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AB - Introduction: It was postulated that a subthreshold defibrillation shock failed to halt ventricular fibrillation because the shock itself reinitiated ventricular fibrillation by falling into the vulnerable period of the wavefronts. Whether or not the timing of the vulnerable period is determined by the ventricular fibrillation cycle length is unknown. Methods and Results: We determined the patterns of epicardial activation in ten dogs by computerized mapping techniques during unsuccessful defibrillation. Lidocaine was then given to prolong the ventricular fibrillation cycle length, and the computerized mapping studies were repeated. The results showed that lidocaine increased the ventricular fibrillation cycle length from 110 ± 13 msec to 156 ± 5 msec (P < 0.001). Among 55 episodes of unsuccessful defibrillation, the site of the earliest postshock activation occurred in the center of the mapped tissue 12 times at baseline and 14 times during lidocaine infusion. At electrodes that registered as postshock early sites, the preshock intervals clustered within a narrow range both before (58 ± 14 msec) and during (101 ± 18 msec, P < 0.001) lidocaine infusion. The correlation between the preshock intervals and the ventricular fibrillation cycle length was significant for these 26 sites (r = 0.87, P < 0.001). Conclusion: We conclude that a vulnerable period is present during ventricular fibrillation, and the timing of the vulnerable period is determined by the ventricular fibrillation cycle length.

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