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The answer to this question lies mostly in etiology. Lidocaine is a pure sodium channel blocker whose therapeutic benefit has been established in ischemically induced arrhythmias. Because many stable ventricular tachyarrhythmias are not induced by ischemia, drugs like procainamide and amiodarone appear to be better choices. Patients with chronic ventricular arrhythmias most often end-up with radio-frequency ablation of anomalous pathways, or an implanted cardioverter/defibrillator.
