Document Detail

Cardiac dysrhythmias induced by extracorporeal shockwave lithotripsy.
MedLine Citation:
PMID:  10479005     Owner:  NLM     Status:  MEDLINE    
PATIENTS AND METHODS: We evaluated in 269 consecutive patients the incidence and gravity of dysrhythmic complications during nonsynchronized extracorporeal shockwave lithotripsy (SWL) using an electromagnetic lithotripter. RESULTS: Dysrhythmia occurred during treatment in 22 patients (8.8%) with no previous cardiac dysrhythmia. Ventricular extrasystoles occurred in 14 patients, atrial extrasystoles in 7 patients, and sinus bradycardia in 1 patient. It was not necessary to terminate treatment because of the occurrence of dysrhythmia in any of the patients. For 13 of the 22 patients (59%), it was sufficient to interrupt the treatment momentarily to obtain resumption of the normal rhythm. For 8 patients (36%), treatment was continued after triggering the release of the shockwaves with the refractory phase of the heart cycle. For one case of bradycardia (42 beats/min), it was possible to continue with the treatment after intravenous administration of atropine 0.5 mg. Pretreatment dysrhythmias were revealed by the electrocardiographic examination in 16 of the patients studied (6.3%). CONCLUSIONS: Extracorporeal shockwave lithotripsy without ECG triggering has been found to be fast and efficient and not correlated with the occurrence of dysrhythmic episodes of any particular clinical significance. No significant correlation was found between the occurrence of dysrhythmia, the side treated, the number and strength of the shockwaves, or the administration of analgesics. It was found, however, that dysrhythmia occurred almost exclusively in treatments involving the kidneys. The ECG-triggering option was indispensable in some patients in order to complete the lithotripsy without complications.
G Zanetti; F Ostini; E Montanari; R Russo; A Elena; A Trinchieri; E Pisani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  13     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:    1999 Jul-Aug
Date Detail:
Created Date:  1999-10-07     Completed Date:  1999-10-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  409-12     Citation Subset:  IM    
Institute of Urology, I.R.C.C.S. Ospedale Maggiore di Milano, Milan, Italy.
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MeSH Terms
Arrhythmias, Cardiac / epidemiology,  etiology*,  physiopathology
Bradycardia / epidemiology,  etiology
Cardiac Complexes, Premature / epidemiology,  etiology
Electromagnetic Phenomena
Heart Conduction System / physiopathology
Kidney Calculi / therapy
Lithotripsy / adverse effects*,  instrumentation
Middle Aged
Refractory Period, Electrophysiological
Ureteral Calculi / therapy

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

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