Recurrent atrial tachyarrhythmia triggered by percutaneous balloon rhizotomy of the trigeminal nerve.
Stimulation of sensory branches of the trigeminal nerve is known to cause sudden bradycardia (trigeminocardiac reflex). However we report a case where percutaneous balloon rhizotomy of the trigeminal ganglion provoked atrial tachyarrhythmias during two separate treatments. On both occasions the patient was treated with antiarrhythmic drugs and reverted to sinus rhythm within days. Our case demonstrates that surgery involving the trigeminal nerve may cause variable cardiovascular effects that are often clinically significant. Possible mechanisms and management of arrhythmias in this setting are discussed.
Fowler
S J
SJ
Department of Anaesthesia, Wellington Hospital, Wellington, New Zealand.
Featherston
M
M
D000368:Aged; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology*; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012008:Recurrence; D013610:Tachycardia / Q000188:drug therapy / Q000209:etiology*; D014276:Trigeminal Nerve; D014277:Trigeminal Neuralgia / Q000628:therapy*