Paroxysmal atrial fibrillation developed during incomplete epidural anesthesia

Min Je Choi, Hye Won Shin, Sung Uk Choi, Ji Yong Park, Hye Won Lee, Hae Ja Lim, Suk Min Yoon, Seong Ho Chang

Research output: Contribution to journalArticle

Abstract

Atrial fibrillation (AF) is the most common sustained tachyarrhythmia, and occurs in organic heart disease such as rheumatic, atherosclerotic and hypertensive heart disease. In recent studies, the sympathetic and parasympathetic nervous systems have been shown to have important roles in initiating paroxysmal AF. We report here a patient who developed paroxysmal AF that might be a result of an imbalance of the sympathetic-parasympathetic systems due to epidural anesthesia, and that was potentiated by pain with inadequate analgesia. A 69-year-old woman was scheduled for operation of a right-sided ankle fracture. Twenty minutes after epidural drug injection, paroxysmal AF occurred. Even after intravenous administration of esmolol and digoxin, AF continued. After transfer to the intensive care unit, her heart rate gradually decreased and AF disappeared. During perioperative anesthetic management, the proper preoperative prevention and intraoperative treatment are needed in AF high-risk patients.

Original languageEnglish
JournalKorean Journal of Anesthesiology
Volume59
Issue numberSUPPL.
DOIs
Publication statusPublished - 2010 Dec 1

Fingerprint

Epidural Anesthesia
Atrial Fibrillation
Heart Diseases
Parasympathetic Nervous System
Ankle Fractures
Epidural Injections
Digoxin
Sympathetic Nervous System
Tachycardia
Intravenous Administration
Analgesia
Intensive Care Units
Anesthetics
Heart Rate
Pain
Pharmaceutical Preparations

Keywords

  • Atrial fibrillation
  • Autonomic nervous system
  • Epidural anesthesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Paroxysmal atrial fibrillation developed during incomplete epidural anesthesia. / Choi, Min Je; Shin, Hye Won; Choi, Sung Uk; Park, Ji Yong; Lee, Hye Won; Lim, Hae Ja; Yoon, Suk Min; Chang, Seong Ho.

In: Korean Journal of Anesthesiology, Vol. 59, No. SUPPL., 01.12.2010.

Research output: Contribution to journalArticle

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AU - Yoon, Suk Min

AU - Chang, Seong Ho

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