Background. Supraventricular tachyarrhythmias (SVTs) represent an intraoperative risk factor that should be always prevented/managed. The commonly used anti-arrhythmic drugs are accompanied by intrinsic hazards, such as pro-arrhythmic and toxic effects or unpredictble onset and duration of action. We underline the therapeutic use of transesophageal atrial pacing (TAP) for the interrupion of particular reentry SVTs occurred durng surgical procedures in general anaesthesia. Methods. Our study was carried out in 25 patients characterized by a personal clinical history of transient tachyarrhythmic epiodes, subjected to general anaesthesia obtained by midazolam, propofol, N2O e O2, sevoflurane, fentanil and vecuronium bromide. We used TAP bursts of 3-5 sec, their minimal pacing rate being equivalent to the tachyarrhythmia cycle length, with an impulse intensity ranging ¬from 18 to 25 mA. In such condi-tions, the rehentry was interuptpted by the induction of refractoriness of the wave-front hat sustained the underlying arrhythmogenic circuit. Results. During the study, the following arrhythmias occurred in 7 out of all patients: 1 type I atrial flutter, 3 nodal tachycardias, 1 antidromic and 2 orthodromic atrioventricular tachycardias, respectively. TAP assured either atrial capture or prompt suppression of arrhythmias in all cases. Low intensity impulses did not ever allow ventricular capture. Conclusions. TAP can be considered as a valid therapeutic device for the management of re-entry SVTs occurred during general anaesthesia, resulting it effective, safe and easy practicable. language: English, Italian

Transesophageal atrial pacing in the management of re-entry supraventricular tachyarrhy-thmias occurring during general anesthesia / Romano, Rocco; Fattorini, F.; Ciccaglioni, A.; Rocco, A.; Moretti, G.; Cappelletti, M.; Pietropaoli, P.. - In: MINERVA ANESTESIOLOGICA. - ISSN 0375-9393. - (2002).

Transesophageal atrial pacing in the management of re-entry supraventricular tachyarrhy-thmias occurring during general anesthesia

ROMANO, Rocco;
2002-01-01

Abstract

Background. Supraventricular tachyarrhythmias (SVTs) represent an intraoperative risk factor that should be always prevented/managed. The commonly used anti-arrhythmic drugs are accompanied by intrinsic hazards, such as pro-arrhythmic and toxic effects or unpredictble onset and duration of action. We underline the therapeutic use of transesophageal atrial pacing (TAP) for the interrupion of particular reentry SVTs occurred durng surgical procedures in general anaesthesia. Methods. Our study was carried out in 25 patients characterized by a personal clinical history of transient tachyarrhythmic epiodes, subjected to general anaesthesia obtained by midazolam, propofol, N2O e O2, sevoflurane, fentanil and vecuronium bromide. We used TAP bursts of 3-5 sec, their minimal pacing rate being equivalent to the tachyarrhythmia cycle length, with an impulse intensity ranging ¬from 18 to 25 mA. In such condi-tions, the rehentry was interuptpted by the induction of refractoriness of the wave-front hat sustained the underlying arrhythmogenic circuit. Results. During the study, the following arrhythmias occurred in 7 out of all patients: 1 type I atrial flutter, 3 nodal tachycardias, 1 antidromic and 2 orthodromic atrioventricular tachycardias, respectively. TAP assured either atrial capture or prompt suppression of arrhythmias in all cases. Low intensity impulses did not ever allow ventricular capture. Conclusions. TAP can be considered as a valid therapeutic device for the management of re-entry SVTs occurred during general anaesthesia, resulting it effective, safe and easy practicable. language: English, Italian
2002
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/76287
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