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Factors that affect the variability in heart rate during endoscopic retrograde cholangiopancreatography
Merete Christensen1, Rebekka Reinert, Verner Rasmussen
1Dept. of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark. merete.christensen@dadlnet.dk
Objective:
To find out if drugs, position, and endoscopic manipulation during endoscopic retrograde cholangiopancreatography (ERCP) influence the changes in the variability of heart rate.
Design:
Single-blind randomised trial.
Subjects:
10 volunteers given butyscopolamine, glucagon, or saline intravenously on three different study days, and 10 patients who had ERCP without butylscopolamine or glucagon.
Main Outcome Measures:
Holter tape analysis for ischaemia and changes in the variability of heart rate.
Results:
5 volunteers developed tachycardia after butylscopolamine, while 2 developed tachycardia after glucagon. During ERCP 9 patients developed tachycardia, and 2 developed myocardial ischaemia. Vagal tone decreased in the volunteers after butylscopolamine, but no changes were seen after glucagon or placebo, or in patients during ERCP.
Conclusions:
Butylscopolamine reduced vagal tone in volunteers. Patients who were having ERCP without butylscopolamine had a stable vagal tone. The previously observed reduced vagal tone during ERCP may therefore be primarily the result of giving butylscopolamine.