| Effects of remifentanil anesthesia on cardiac electrophysiologic properties in children undergoing catheter ablation of supraventricular tachycardia. | |
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MedLine Citation:
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PMID: 20814785 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Remifentanil is commonly used during anesthesia in pediatric electrophysiologic studies (EPS). The purpose of this study is to determine the effects of remifentanil on the cardiac electrophysiologic properties of children undergoing ablation of supraventricular tachycardia (SVT). A prospective study was performed in patients undergoing EPS before ablation of SVT. Each patient received two different anesthetic protocols: protocol 1 = propofol (200 mcg/kg/min) and protocol 2 = propofol (120 mcg/kg/min) plus remifentanil (0.3 mcg/kg/min). EPS data were measured during the steady state of each protocol. Paired Student t test was performed for analysis of continuous data. All p values <0.05 were considered statistically significant. Fifteen patients were enrolled between April 2005 and January 2006. The mean age was 13.3 ± 2.9 years (range 6.7 to 17.7). Seven patients had atrioventricular (AV) nodal re-entry tachycardia; 5 patients had Wolff-Parkinson-White syndrome; 2 patients had a concealed accessory pathway; and 1 patient was not inducible. Of the 14 patients who underwent ablation, 13 (93%) achieved successful. The baseline sinus cycle length extended from 884 ± 141 ms during protocol 1 to 980 ± 165 ms during protocol 2 (p = 0.01), and the Wenckebach cycle length lengthened from 377 ± 96 ms to 406 ± 109 ms (p = 0.01). No other variables measured (atrial-His (AH) and His-ventricular (HV) interval, atrioventricular node (AVN), and atrial, ventricular, and accessory pathway effective refractory periods) changed significantly between the two different protocols. In pediatric patients undergoing EPS before ablation of SVT, remifentanil appears to slow both sinus and AV nodal function. These effects should be taken into consideration when performing EPS. |
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Authors:
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Alisa Niksch; Leonardo Liberman; Anthony Clapcich; Johanna C Schwarzenberger; Eric S Silver; Robert H Pass |
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Publication Detail:
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Type: Journal Article Date: 2010-09-03 |
Journal Detail:
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Title: Pediatric cardiology Volume: 31 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1079-82 Citation Subset: IM |
Affiliation:
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Pediatric Arrhythmia Service, The Heart Institute for Children, Oak Lawn, IL, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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