Ewha Med J.  2012 Sep;35(2):119-123. 10.12771/emj.2012.35.2.119.

Atrial Fibrillation during General Anesthesia Induction and Paroxysmal Supraventricular Tachycardia on Emergence

• Bang YS
• Shin DW
• Lee TK
• Park CH
• Gill HJ
• Lee JY

• KMID: 2284003
• DOI: http://doi.org/10.12771/emj.2012.35.2.119

Abstract

A healthy 35-year-old man who was scheduled for closed reduction of nasal bone fracture developed atrial fibrillation during induction of general anesthesia after intravenous glycopyrrolate injection. During emergence of general anesthesia, atrial fibrillation was suddenly changed to paroxysmal supraventricular tachycardia with 200 beat per minute and lasted for about 10 seconds. Because blood pressure was stable, esmolol was used to reduce ventricular response. At recovery room, ventricular response reduction about 55 beat per minute was observed after intravenous injection of verapamil 5 mg. Thereafter, the rhythm was returned to normal sinus rhythm with bradycardia.

Keyword

Atrial fibrillation; General anesthesia; Paroxysmal tachycardia

MeSH Terms

Anesthesia, General
Atrial Fibrillation
Blood Pressure
Bradycardia
Glycopyrrolate
Injections, Intravenous
Nasal Bone
Propanolamines
Recovery Room
Tachycardia, Paroxysmal
Tachycardia, Supraventricular
Verapamil
Glycopyrrolate
Propanolamines
Verapamil

Figure

• 

  Fig. 1 Electrocardiographic finding before surgery. Normal sinus rhythm (64 beats/min) is observed.

• 

  Fig. 2 Electrocardiographic finding at the recovery room. Atrial fibrillation with irregular ventricular response (95 beats/min) is observed.

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  Fig. 3 Electrocardiographic finding after verapamil infusion. Slow ventricular response (55 beats/min) is observed, but atrial fibrillation is continued.

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  Fig. 4 Electrocardiographic findings on the 10th day after surgery. Normal sinus rhythm with bradycardia (46 beats/min) is observed.

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