[Intraoperative ventricular or supraventricular tachycardia? A case report]
Tomoaki Yanaru1, Yasuyuki Sugi, Kazuo Higa
1Department of Anesthesiology, Fukuoka University Faculty of Medicine, Fukuoka 814-0180.
Masui. the Japanese Journal of Anesthesiology
|September 22, 2009
Summary
A patient experienced wide QRS complex tachycardia during anesthesia, initially suspected as ventricular. Postoperative studies revealed ectopic atrial tachycardia, leading to successful catheter ablation.
Area of Science:
- Cardiology
- Anesthesiology
- Electrophysiology
Background:
- A 68-year-old male with a history of paroxysmal supraventricular tachycardia presented for surgery.
- General anesthesia was induced for the planned procedure.
Observation:
- One minute after anesthesia induction, the patient developed wide QRS complex tachycardia.
- The tachycardia was initially presumed to be ventricular in origin, with absent radial artery pulsations.
- Intravenous antiarrhythmic drugs were administered, and the surgery was postponed.
Findings:
- Postoperative electrophysiological study identified the underlying rhythm as ectopic atrial tachycardia.
- A precise review of the intraoperative electrocardiogram revealed regular P waves.
- The intraoperative tachycardia was reclassified as supraventricular in origin.
Implications:
- This case highlights the importance of careful electrocardiogram review during anesthesia.
- Misdiagnosis of wide QRS complex tachycardia can lead to inappropriate treatment.
- Electrophysiological study and catheter ablation are effective for managing ectopic atrial tachycardia.
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