Prophylaxis of primary ventricular fibrillation in acute myocardial infarction. The case against lignocaine

Abstract

The prevention of primary ventricular fibrillation may be viewed as an important goal in the coronary care unit, particularly if the time delay to hospital admission can be reduced. The most widely studied agent in the prophylaxis of this arrhythmia has been lignocaine, but despite numerous reports considerable controversy still surrounds its use. There are two fundamental questions: Is lignocaine effective at preventing primary ventricular fibrillation or its recurrence? Should it be used routinely for these purposes? Although several recent editorials and reviews have recommended the use of routine prophylactic lignocaine, its current role in the coronary care unit has evolved in part through emotive argument not always scientifically based. A critical review of the subject is given.