Related Experiment Videos
Cardiac rhythm in men during cystoscopy
Insights
Men with heart disease experienced more cardiac arrhythmias during cystoscopy. Local lidocaine anesthesia increased ventricular ectopic beats compared to general or epidural anesthesia, though no permanent complications occurred.
Area of Science:
- Urology
- Cardiology
- Anesthesiology
Background:
- Cardiac rhythm disturbances can occur during cystoscopy.
- Patients with pre-existing heart disease may be at higher risk.
- The type of anesthesia used might influence the incidence of arrhythmias.
Purpose of the Study:
- To prospectively monitor cardiac rhythm in men undergoing cystoscopy.
- To investigate the association between heart disease and arrhythmias during the procedure.
- To compare the incidence of arrhythmias based on the type of anesthesia administered.
Main Methods:
- Prospective cardiac rhythm monitoring in 69 men during 191 cystoscopies.
- Assessment of arrhythmias in patients with and without heart disease.
- Analysis of arrhythmias in relation to local lidocaine, general, and epidural anesthesia.
Main Results:
- Men with heart disease had a significantly higher proportion of procedures with ectopic beats (76%) compared to those without (16%).
- Local lidocaine anesthesia was associated with a significantly higher rate of ventricular ectopic beats (48.7%) than general (8%) or epidural (13.8%) anesthesia.
- Plasma lidocaine was detected following intraurethral injection; no significant difference in supraventricular ectopic beats was observed across anesthetic groups.
Conclusions:
- Cystoscopy is associated with an increased risk of arrhythmias, particularly in men with heart disease.
- Local lidocaine anesthesia increases the risk of ventricular ectopic beats during cystoscopy.
- While potentially serious dysrhythmias were observed, no permanent cardiovascular complications occurred.
Abstract:
Cardiac rhythm was monitored prospectively in 69 men during 191 cystoscopies. Ectopic beats from ventricular and supraventricular foci occurred in a significantly greater proportion of procedures in men with (76 per cent) compared to men without (16 per cent) heart disease. Other arrhythmias occurred to a lesser extent but there was no significant difference between men with and without heart disease. Plasma lidocaine was detected in significant amounts following intraurethral injection used for local anesthesia. Comparison of the types of arrhythmias that occurred during cytoscopy and the type of anesthetic used showed that significantly fewer ventricular ectopic beats occurred with general (8 per cent) or epidural anesthesia (13.8 per cent) as opposed to local lidocaine anesthesia (48.7 percent). Among the 3 anesthetic groups there was no difference with respect to frequency of supraventricular ectopic beats. No permanent cardiovascular complications occurred although several potentially serious dysrhythmias were seen.