Document Detail

Complete atrioventricular block during anesthesia.
MedLine Citation:
PMID:  10210052     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe a case of asymptomatic first degree atrioventricular block with a bifascicular block that progressed to complete atrioventricular block during anesthesia. This potentially fatal block was successfully treated with transesophageal ventricular pacing. CLINICAL FEATURES: A 67-yr-old man was scheduled for microvascular decompression of the right trigeminal nerve under general anesthesia. His preoperative ECG showed first degree atrioventricular block with complete right bundle branch block and left anterior hemiblock, but he had experienced no cardiovascular symptoms. Anesthesia was induced with sevoflurane 5%, and maintained with isoflurane 1.5-2% in oxygen. Fifteen minutes later in the left lateral decubitus position, the systolic arterial blood pressure suddenly decreased from 80 mmHg to 0 mmHg. Then, the ECG abruptly changed from sinus rhythm to complete atrioventricular block. The heart was unresponsive to drug therapy such as atropine 1.3 mg and isoproterenol 0.5 mg, or transcutaneous pacing but transesophageal pacing was successful. CONCLUSION: Asymptomatic first degree atrioventricular block with bifascicular block advanced to complete atrioventricular block during anesthesia. The block was successfully managed with transesophageal pacing.
K Mamiya; J Aono; M Manabe
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  46     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-05-27     Completed Date:  1999-05-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  265-7     Citation Subset:  IM    
Department of Anesthesiology, Kochi Medical School, Japan.
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MeSH Terms
Anesthesia / adverse effects*
Cardiac Pacing, Artificial
Heart Block / etiology*

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

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