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March 3, 1989

Prophylactic Lidocaine in Acute MI

Author Affiliations

Needham, Mass

Needham, Mass

JAMA. 1989;261(9):1278. doi:10.1001/jama.1989.03420090042020

To the Editor.—  MacMahon et al1 recently reported the effect of prophylactic lidocaine in the therapy of acute myocardial infarction, noting that, even today, we do not have enough evidence to support such use of prophylactic lidocaine. In their extensive reference list, the authors' earliest relevant reference is from 1967, in which Gianelly et al2 suggest the possible use of lidocaine to prevent ventricular arrhythmias in the coronary care unit setting.In the same year, our detailed report in another journal3 dealt with the prophylactic use of procainamide and certain other intramuscular drugs in patients before admission to the hospital with coronary diagnoses. The primary point of our lengthy report and subsequent commentary4 was to indicate that it was not possible to recommend any single-drug therapy in the prophylactic treatment of acutely ill coronary patients. Rather, we pointed out that one probably must use a combination