Korean J Anesthesiol.  2017 Apr;70(2):120-126. 10.4097/kjae.2017.70.2.120.

Intraoperative management of critical arrhythmia

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
  • 2Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. yshkim75@naver.com

Abstract

The incidence of intraoperative arrhythmia is extremely high, and some arrhythmias require clinical attention. Therefore, it is essential for the anesthesiologist to evaluate risk factors for arrhythmia and understand their etiology, electrophysiology, diagnosis, and treatment. Anesthetic agents reportedly affect normal cardiac electrical activity. In the normal cardiac cycle, the sinoatrial node initiates cardiac electrical activity through intrinsic autonomous pacemaker activity. Sequential atrial and ventricular contractions result in an effective cardiac pumping mechanism. Arrhythmia occurs due to various causes, and the cardiac pumping mechanism may be affected. A severe case may result in hemodynamic instability. In this situation, the anesthesiologist should eliminate the possible causes of arrhythmia and manage the condition, creating hemodynamic stability under proper electrocardiographic monitoring.

Keyword

Anesthesia; Cardiac arrhythmias; Cardiac cycle

MeSH Terms

Anesthesia
Anesthetics
Arrhythmias, Cardiac*
Diagnosis
Electrocardiography
Electrophysiology
Hemodynamics
Incidence
Risk Factors
Sinoatrial Node
Anesthetics
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