What is the second-line anti-dysrhythmic after lidocaine?

What is the second-line anti-dysrhythmic after lidocaine?

• A. Procainamide
• B. Amiodarone
• C. Adenosine
• D. Esmolol

Answer: (A)

In treating ventricular tachyarrhythmias, lidocaine is used first to suppress ischemia-related ventricular ectopy. If the rhythm persists after lidocaine, the next antiarrhythmic typically considered is procainamide. It’s a Class IA sodium channel blocker that also prolongs the action potential, which helps slow conduction and increase refractoriness in the ventricles. This makes it effective for terminating reentrant VT and suppressing ectopy when lidocaine isn’t enough or when amiodarone isn’t available. While amiodarone is commonly used today, procainamide has long been the standard second-line option in many protocols. Adenosine isn’t effective for ventricular tachycardia, and esmolol is more aimed at certain supraventricular tachycardias or specific clinical contexts, not the typical next step after lidocaine for VT.

In treating ventricular tachyarrhythmias, lidocaine is used first to suppress ischemia-related ventricular ectopy. If the rhythm persists after lidocaine, the next antiarrhythmic typically considered is procainamide. It’s a Class IA sodium channel blocker that also prolongs the action potential, which helps slow conduction and increase refractoriness in the ventricles. This makes it effective for terminating reentrant VT and suppressing ectopy when lidocaine isn’t enough or when amiodarone isn’t available. While amiodarone is commonly used today, procainamide has long been the standard second-line option in many protocols. Adenosine isn’t effective for ventricular tachycardia, and esmolol is more aimed at certain supraventricular tachycardias or specific clinical contexts, not the typical next step after lidocaine for VT.