Dan-Dominic Ionescu *, Vasile Greere *, Mariana Jinga **, Constantin Mircioiu ***, Eduard Dănăilă **
* Dan-Dominic Ionescu, Vasile Greere – Centrul de Boli Cardiovasculare al Armatei
** Mariana Jinga, Eduard Dănăilă – Spitalul Clinic Militar Central
*** Constantin Mircioiu – Centrul de Cercetări Stiinţifice Medico-Militare
Abstract
Most antiarrhythmic drugs significantly alter the values of signal averaged electrocardiogram (SAECG) parameters but orally administered lidocaine (OAL), which might be a reasonable therapeutic choice for ventricular arrhythmia, has uncertain effects. Methods: 15 patients with ischemic heart disease and frequent ventricular premature beats (VPB) on 24 hour Holter monitoring were treated with oral lidocaine 550mg t.i.d. for four days. Repeated SAECG recordings were made at baseline and during the third day of treatment three hours after the noon dose of OAL. The recordings were analyzed using high-pass filters set at 40 Hz. Ventricular late potentials (LPs) were considered to be present when all of the SAECG parameters were: filtered QRS duration (QRSD) > 114ms, low amplitude signal duration (LASD) > 38 ms and root mean square voltage in the last 40 ms of the filtered QRS (RMS 40) < 20 mV. Statistical analyses were done using the paired Student t-test. Results: Before OAL, LPs were absent in all but one patient who had slightly abnormal values of all SAECG parameters. After OAL (table), QRSD increased and RMS 40 decreased significantly (p< 0.05) remaining within normal limits and LASD did not change. The values for the patient with LP were not influenced by treatment. Abnormal values after OAL were recorded for QRSD in 1 patients and for RMMS 40 and LASD in 3 and 2 different patients respectively. Conclusion: orally administered lidocaine does not significantly influence the parameters of signal averaged electrocardiogram in patients with ischemic heart disease.