Korean J Anesthesiol.  2015 Aug;68(4):415-419. 10.4097/kjae.2015.68.4.415.

Tachycardia-bradycardia syndrome in a patient with atrial fibrillation: a case report

• Choi SH
• Choi SL
• Lee BY
• Jeong MA

• KMID: 2152888
• DOI: http://doi.org/10.4097/kjae.2015.68.4.415

Abstract

An 83-year-old woman was scheduled for a second transurethral resection of a bladder tumor. The preoperative electrocardiogram evaluation revealed atrial fibrillation with a slow ventricular response (ventricular rate: 59 /min). After intravenous injection of 1% lidocaine 40 mg and propofol 60 mg, the ventricular rate increased to 113 beats/min and then fell rapidly to 27 beats/min. Blood pressure was 70/40 mmHg. Later an atrial fibrillation rhythm, with a ventricular rate of 100-130 beats/min, was observed together with a sinus pause and sinus rhythm with a ventricular rate of 40-50 beats/min. An external pacemaker was applied and set at 60 mA, 40 counts. After the patient regained consciousness, she presented an alert mental state and had no chest symptoms. She was discharged 2 weeks later without complications after insertion of a permanent pacemaker.

Keyword

Artificial cardaic pacing; Atrial fibrillation; Sick sinus syndrome

MeSH Terms

Aged, 80 and over
Atrial Fibrillation*
Blood Pressure
Consciousness
Electrocardiography
Female
Humans
Injections, Intravenous
Lidocaine
Propofol
Sick Sinus Syndrome
Thorax
Urinary Bladder Neoplasms
Lidocaine
Propofol