The effect of lidocaine on the conduction of extrasystoles was studied in 8 open-chest dogs after atrioventricular nodal block. Simultaneous recording of endocardial and epicardial activation provided separate measures of endocardial (Purkinje) conduction as well as myocardial (muscle) conduction. Lidocaine (1.25--10.0 mg/kg) caused a dose-dependent slowing of conduction of midrange extrasystoles (250--400 ms) in both the Purkinje system and the myocardium, which became statistically significant at doses larger than 1.25 mg/kg. On the other hand, low doses of lidocaine caused speeding of early extrasystoles, i.e., coupling intervals (less than 250 ms) in the Purkinje system but not in the myocardium. Measurement of transmural conduction time as a function of coupling interval revealed a period of "apparent" supernormal conduction through ventricular muscle that was eliminated at high doses of lidocaine.
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