Ventricular Arrhythmias after Intravenous Sodium Lactate in Heart Block

Abstract

Molar sodium lactate has been described as a safe and effective agent in the treatment of bradycardia accompanying complete heart block. However, in 12 patients with heart block, hypertonic lactate infusions produced ventricular tachycardia in 6 and an increased idioventricular rate in only 4. Isopropylnorepinephrine was more effective and without such hazard. The effects of alkalosis from molar lactate, 5 per cent sodium bicarbonate, and hyperventilation are compared. Of these 3, lactate was productive of the greatest ventricular acceleration.