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Continuous electrocardiographic monitoring during balloon dilatation in achalasia
Insights
Electrocardiographic changes during balloon dilatation for achalasia are common, especially in patients with ischemic heart disease (IHD). These transient changes typically do not require treatment but warrant preparedness for emergencies.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Procedures
Background:
- Achalasia is a rare esophageal motility disorder.
- Balloon dilatation is a common treatment for achalasia.
- Cardiovascular monitoring during endoscopic procedures is crucial.
Purpose of the Study:
- To investigate electrocardiographic (ECG) changes during balloon dilatation for achalasia.
- To assess the incidence and nature of ECG abnormalities.
- To evaluate the impact of ischemic heart disease (IHD) on these changes.
Main Methods:
- Continuous ECG monitoring was performed on nine patients undergoing balloon dilatation for achalasia.
- Patients were monitored before, during, and after the procedure.
- Three patients had pre-existing ischemic heart disease (IHD).
Main Results:
- Transient ECG abnormalities, including sinus tachycardia and ectopic beats, were observed in most patients.
- ST-segment depression and T-wave flattening also occurred.
- Abnormalities were more frequent in patients with IHD.
Conclusions:
- Balloon dilatation for achalasia can induce transient ECG changes.
- These changes are more prevalent in patients with IHD.
- Emergency equipment and drugs should be readily available during the procedure, especially for patients with IHD.
Abstract:
Electrocardiographic (ECG) changes in nine patients under continuous ECG monitoring before, during and after balloon dilatation for achalasia were followed; of these, three had ischaemic heart disease (IHD). One or several abnormalities including sinus tachycardia, supraventricular or ventricular ectopic beats, S-T segment depression and T-wave flattening appeared during the procedure; these were more commonly found in patients with IHD. Despite the high incidence of recorded ECG abnormalities, these were transient, and no treatment was needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during balloon dilatation for achalasia, particularly when this procedure is performed in patients with IHD.