Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Corresponding author: Jong-Yeon Lee, Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 463-712, Korea. Tel: 82-31-780-5433, Fax: 82-31-701-9433, jongyeonl@yahoo.co.kr
• Received: June 8, 2012 • Accepted: June 27, 2012
A healthy 35-year-old man who was scheduled for closed reduction of nasal bone fracture developed atrial fibrillation during induction of general anesthesia after intravenous glycopyrrolate injection. During emergence of general anesthesia, atrial fibrillation was suddenly changed to paroxysmal supraventricular tachycardia with 200 beat per minute and lasted for about 10 seconds. Because blood pressure was stable, esmolol was used to reduce ventricular response. At recovery room, ventricular response reduction about 55 beat per minute was observed after intravenous injection of verapamil 5 mg. Thereafter, the rhythm was returned to normal sinus rhythm with bradycardia.
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Atrial Fibrillation during General Anesthesia Induction and Paroxysmal Supraventricular Tachycardia on Emergence
Fig. 1
Electrocardiographic finding before surgery. Normal sinus rhythm (64 beats/min) is observed.
Fig. 2
Electrocardiographic finding at the recovery room. Atrial fibrillation with irregular ventricular response (95 beats/min) is observed.
Fig. 3
Electrocardiographic finding after verapamil infusion. Slow ventricular response (55 beats/min) is observed, but atrial fibrillation is continued.
Fig. 4
Electrocardiographic findings on the 10th day after surgery. Normal sinus rhythm with bradycardia (46 beats/min) is observed.
Fig. 1
Fig. 2
Fig. 3
Fig. 4
Atrial Fibrillation during General Anesthesia Induction and Paroxysmal Supraventricular Tachycardia on Emergence
