New-Onset Intermittent Deceleration-Dependent Left Bundle Branch Block Following Induction of General Anesthesia in a
Sengottaian Sivakumar1, Mark J Young2, Lazar Popilevsky1
1Anesthesiology, Metropolitan Hospitals, New York, USA.
Cureus
|March 1, 2024
Summary
This case report details a rare instance of deceleration-dependent aberrancy (DDA), a type of left bundle branch block, occurring during general anesthesia in a patient without prior heart issues. Careful monitoring and medication helped manage this transient condition.
Area of Science:
- Anesthesiology
- Cardiology
- Electrophysiology
Background:
- Anesthetic agents can impact cardiac conduction.
- Deceleration-dependent aberrancy (DDA) is a rare conduction abnormality.
- Patients without cardiac history may still experience intraoperative conduction issues.
Observation:
- A patient developed transient left bundle branch block (LBBB) with deceleration-dependent characteristics after anesthesia induction.
- The LBBB appeared at heart rates below 60 bpm and resolved above 90 bpm.
- Hemodynamics remained stable, and the condition was managed with glycopyrrolate.
Findings:
- Postoperative evaluations showed normal biventricular function.
- A small to moderate reversible perfusion defect was noted on nuclear stress test.
- The patient remained asymptomatic post-surgery.
Implications:
- Highlights the importance of recognizing rate-dependent LBBB as a potential intraoperative complication.
- Emphasizes the need for vigilance and tailored anesthetic management in patients at risk for conduction abnormalities.
- Underscores the interaction between anesthesia and cardiac electrophysiology, warranting further research.
Keywords:
anesthetic agentscardiac conduction systemcardiac electrophysiologydeceleration-dependent aberrancy (dda)intraoperative monitoringleft bundle branch block (lbbb)perioperative managementrate-dependent conduction abnormalitiesMore Related Videos
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