and nonsustained VT, rhythms that were believed to pres-
age VF/pVT. Later studies noted a disconcerting association
between lidocaine and higher mortality after acute myocardial
infarction, possibly due to a higher incidence of asystole and
bradyarrhythmias; the routine practice of administering pro-
phylactic lidocaine during acute myocardial infarction was
abandoned.110,111 The use of lidocaine was explored in a mul-
tivariate and propensity score–adjusted analysis of patients
resuscitated from out-of-hospital VF/pVT arrest. In this obser-
vational study of 1721 patients, multivariate analysis found the
prophylactic administration of lidocaine before hospitalization
was associated with a significantly lower rate of recurrent VF/
pVT and higher rates of hospital admission and survival to
hospital discharge. However, in a propensity score–adjusted
analysis, rates of hospital admission and survival to hospital
discharge did not differ between recipients of prophylactic
lidocaine as compared with nonrecipients, although lidocaine
was associated with less recurrent VF/pVT and there was no
evidence of harm.112 Thus, evidence supporting a role for pro-
phylactic lidocaine after VF/pVT arrest is weak at best, and
nonexistent for cardiac arrest initiated by other rhythms.