Use of lignocaine and atropine autoinjectors for patients at high risk of sudden death and reinfarction after myocardial infarction.

: Twenty-five patients entered a prospective study to assess the usefulness of atropine and lignocaine autoinjectors for coronary events after discharge from hospital after a definite, complicated myocardial infarction. They were selected on the basis of being at high risk of sudden death and reinfarction, being less than 70 years of age and being able to maintain a close liaison with the hospital. One or both autoinjectors were used for five reported events (four of collapse, one of chest pain) in four patients, with possible benefit in two instances. Six patients collapsed and died, despite the use of autoinjectors in three of their fatal collapses. In our experience, the use of autoinjectors has been of little observable benefit, perhaps due to the lack of specific warning symptoms preceding the onset of lethal arrhythmias, so that the injectors were often used for unobserved collapses when the chances of survival were remote.