[Bradycardia-tachycardia syndrome during spinal anesthesia].
A 78-year-old man developed bradycardia with decreased level of consciousness followed by sinus arrest during femoropopliteal bypass surgery under subarachnoid anesthesia. Early in the recovery period, a similar clinical picture developed, with bradycardia but no change in level of consciousness. Sinus node automaticity or sinoatrial conduction abnormalities were suspected, and a 24-hour Holter electrocardiogram revealed bradycardia-tachycardia syndrome. The patient was prescribed amiodarone and anticoagulant therapy with acenocoumarol; no further episodes occurred during hospitalization. Bradycardia-tachycardia syndrome is a sinus node disorder that manifests intermittently. It can become apparent during or shortly after surgery, leading to problems of differential diagnosis.
Servicio de Anestesiología y Reanimación, Hospital Universitari de Girona Doctor Josep Trueta Av. de França s/n, 17007 Girona. anestesia@htrueta.scs.es
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Arxer
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Novoa
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Vieito Amor
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J
Hernández Iniesta
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Villalonga
D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000775:Anesthesia, Spinal; D000783:Aneurysm / Q000601:surgery; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001919:Bradycardia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005263:Femoral Artery / Q000601:surgery; D006323:Heart Arrest / Q000209:etiology; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011150:Popliteal Artery / Q000601:surgery; D013577:Syndrome; D013615:Tachycardia, Sinoatrial Nodal Reentry / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D000638:Amiodarone