[A case of ventricular fibrillation during emergency clipping operation for cerebral aneurysm]

A 59 year-old woman with subarachnoid hemorrhage underwent emergency neck clipping of cerebral aneurysm. Her preoperative examination showed atrial fibrillation, pulmonary edema and hypokalemia. Ventricular fibrillation developed immediately after clipping of the aneurysm and recurred 7 times thereafter during the surgery. Hypokalemia was corrected, and hypoxemia and other factors leading to ventricular fibrillation were excluded. RR interval was prolonged prior to ventricular fibrillation. Therefore intravenous temporary cardiac pacemaker was inserted immediately after the end of the surgery. It prevented successfully the prolongation of RR interval as well as ventricular fibrillation. The present case suggests that we should pay attention to the possibility of ventricular fibrillation during emergency radical surgery for ruptured cerebral aneurysm, and that cardiac pacemaker is useful to prevent ventricular fibrillation following prolongation of RR interval.