Document Detail


Randomized study of propofol effect on electrophysiological properties of the atrioventricular node in patients with nodal reentrant tachycardia.
MedLine Citation:
PMID:  17201845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) is probably the most common form of paroxysmal supraventricular tachycardia. Percutaneous catheter ablation is a technique to interrupt cardiac conduction pathways selectively. The anesthetist is challenged to provide a safe anesthetic which takes into account the electrophysiologist's requirements for minimal cardiac conduction interference. Propofol is an ideal drug. However, previous studies have shown that the infusion of propofol has sometimes been associated with bradyarrhythmias or conversion of arrhythmias to sinusal rhythm. The purpose of this report is to verify the interferences of propofol in the electrophysiological properties of the atrioventricular (AV) node conduction system in patients with AVNRT. METHODS: Patients were randomly assigned to receive either a placebo or propofol at sedative doses. An electrophysiological study was performed consisting of measuring the anterograde (AERPFP) and retrograde effective refractory period of the fast (RERPFP) and the anterograde effective refractory period of the slow (AERPSP) AV nodal pathway. Reciprocating tachycardia was induced and the cycle length (CL) and atrial-His (AH), His-ventricular (HV), and ventriculoatrial (VA) intervals were measured. RESULTS: Propofol did not cause alteration (P > 0.05) in the AERPFP or RERPFP and the AERPSP AV nodal pathway. The AH, HV, and VA intervals were not affected. Sustained reciprocating tachycardia could be induced in the all patients. All slow pathways were successfully identified and ablated. CONCLUSION: Propofol has no effect on the electrophysiological properties of the AV node conduction system. It is thus a suitable anesthetic agent for use in patients undergoing ablative procedures.
Authors:
Paulo Warpechowski; Gustavo G Lima; Cláudio M Medeiros; Ari Tadeu L Santos; Marcelo Kruse; Marcelo H Migloransa; Renato A K Kalil
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  29     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-01-04     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1375-82     Citation Subset:  IM    
Affiliation:
Institute of Cardiology of Rio Grande Do SUL/FUC, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, Brazil. pwar2002@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrioventricular Node / drug effects*,  physiopathology*
Cross-Over Studies
Double-Blind Method
Female
Humans
Hypnotics and Sedatives / administration & dosage
Male
Propofol / administration & dosage*
Tachycardia, Atrioventricular Nodal Reentry / diagnosis,  drug therapy*,  physiopathology*,  surgery
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 2078-54-8/Propofol

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


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