Document Detail

Anesthetic management of an AAI pacemaker patient with paroxysmal atrial fibrillation during colorectal surgery.
MedLine Citation:
PMID:  16905084     Owner:  NLM     Status:  MEDLINE    
Perioperative management of patients with cardiac pacemakers may be challenging because of the increasing sophistication of these devices. We report a case of a patient with paroxysmal atrial fibrillation (PAF) and with a permanent AAIR (bipolar atrial-inhibited adaptive rate) pacemaker who suffered life-threatening episodes of arrhythmias during operation. The first episode was vagally induced PAF during bowel manipulation; the second, induced by the increased pacing threshold from the external electric cardioversion and hyperkalemia. Transcutaneous pacing provided cardiac pacing and stabilized the patient during the second episode. Thorough preoperative evaluation and prophylactic placement of temporary pacing or at least transcutaneous pacing are important for the avoidance and minimization of intraoperative complications in patients with sick sinus syndrome and with an AAI (atrial inhibited) pacemaker.
Jui-An Lin; Cecil O Borel; Wen-Been Wang; Chih-Shung Wong; Chun-Chang Yeh; Chih-Ping Yang; Ching-Tang Wu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  18     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-14     Completed Date:  2006-12-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-5     Citation Subset:  IM    
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 11490, Taiwan, and Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Amiodarone / administration & dosage
Anesthesia, General / methods*
Anti-Arrhythmia Agents / administration & dosage
Atrial Fibrillation / complications*,  drug therapy
Atropine / administration & dosage
Bradycardia / complications,  drug therapy
Calcium Gluconate / administration & dosage
Cardiotonic Agents / administration & dosage
Colorectal Surgery*
Dopamine / administration & dosage
Electric Countershock / methods
Epinephrine / administration & dosage
Fatal Outcome
Heart Arrest / complications,  drug therapy
Heart Massage / methods
Hypotension / drug therapy,  etiology
Intraoperative Complications / therapy
Multiple Organ Failure
Pacemaker, Artificial*
Tachycardia, Ventricular / etiology,  therapy
Vasoconstrictor Agents / administration & dosage
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Cardiotonic Agents; 0/Vasoconstrictor Agents; 1951-25-3/Amiodarone; 299-28-5/Calcium Gluconate; 51-43-4/Epinephrine; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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