A Galvanizing Solution: Colonoscopy Bowel Preparation as a Trigger for Supraventricular Tachycardia

Area of Science:

• Cardiology
• Gastroenterology

Background:

• Polyethylene glycol (PEG)-based solutions are standard for colonoscopy preparation.
• Rare cardiac events, including supraventricular tachycardia (SVT), have been reported with PEG use.

Purpose of the Study:

• To identify patient characteristics associated with developing SVT after ingesting GoLYTELY (PEG 3350 and electrolytes oral solution).

Main Methods:

• Retrospective observational cohort study.
• Reviewed electronic medical records of patients who developed SVT post-GoLYTELY ingestion (April 2012-March 2019).

Main Results:

• 16 patients developed new-onset SVT; most common was atrial fibrillation (75%).
• Patients were predominantly male (93.8%), mean age 69 years.
• Common comorbidities included hypertension (87.5%), hyperlipidemia (56.3%), and diabetes (37.5%).
• Echocardiograms revealed dilated atria and left-ventricular hypertrophy in a significant percentage of patients.

Conclusions:

• Certain individuals may be predisposed to atrial arrhythmias after PEG solution ingestion.
• Hypothesized contributing factors include atrial dilation, sympathovagal discharge, and cellular electrolyte shifts.