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European Heart Journal 1985 6(1):57-66;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Effects of lidocaine, procainamide, metoprolol, digoxin and atropine on the conduction of premature ventricular beats in man

N. EDVARDSSON, I. HIRSCH and S. B. OLSSON

Division of Cardiology, Department of Medicine I, Sahlgren's Hospital, and the Department of Applied Electronics, Chalmers University of Technology Göteborg, Sweden

Received 11 June 1984; revised 24 October 1984; .

Address for reprints: Nils Edvardsson. M.D., Division of Cardiology. Department of Medicine I, Sahlgren's Hospital, S-413 45 Göteborg, Sweden.

Abstract

The acute electrophysiologic effects of clinical doses of procainamide, lidocaine, metoprolol, digoxin and atropine upon the conduction of ventricular premature beats, were studied in 48 healthy volunteers. The conduction time of the first premature beat, induced 1 ms after the ventricular effective refractory period (VERP) was longer than that of the basic paced beats in 41 of the 48 subjects (85%); in 31 (65%) the delay was >5 ms, indicating subnormal conduction. Digoxin decreased the delay so that it became insignificant, while, after procainamide, the delay increased significantly. The other agents did not significantly affect the subnormal conduction. The mean conduction times of premature beats, induced 30–50 ms after the VERP, were shorter than the basic conduction time in 43 of the 48 subjects (90%), and in 25 (52%) the decrease was > 5 ms, showing supernormal conduction. Lidocaine abolished the supernormal conduction. The other agents did not significantly alter the supernormal conduction. In the healthy heart, sub- and supernormal conduction of premature beats seem to be common phenomena, and seem, with few exceptions, to be largely unaffected by clinical doses of procainamide, lidocaine, metoprolol, digoxin and atropine.

Key Words: Monophasic action potentials • lidocaine • procainamide • metoprolol • digoxin • atropine • premature beats


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