title: Randomized study of propofol effect on electrophysiological properties of the atrioventricular node in patients with nodal reentrant tachycardia.
abstract: BACKGROUND
  Atrioventricular nodal reentrant tachycardia (AVNRT) is probably the most common form of paroxysmal supraventricular tachycardia. Percutaneous catheter ablation is a technique to interrupt cardiac conduction pathways selectively. The anesthetist is challenged to provide a safe anesthetic which takes into account the electrophysiologist's requirements for minimal cardiac conduction interference. Propofol is an ideal drug. However, previous studies have shown that the infusion of propofol has sometimes been associated with bradyarrhythmias or conversion of arrhythmias to sinusal rhythm. The purpose of this report is to verify the interferences of propofol in the electrophysiological properties of the atrioventricular (AV) node conduction system in patients with AVNRT.
  
  
  METHODS
  Patients were randomly assigned to receive either a placebo or propofol at sedative doses. An electrophysiological study was performed consisting of measuring the anterograde (AERPFP) and retrograde effective refractory period of the fast (RERPFP) and the anterograde effective refractory period of the slow (AERPSP) AV nodal pathway. Reciprocating tachycardia was induced and the cycle length (CL) and atrial-His (AH), His-ventricular (HV), and ventriculoatrial (VA) intervals were measured.
  
  
  RESULTS
  Propofol did not cause alteration (P > 0.05) in the AERPFP or RERPFP and the AERPSP AV nodal pathway. The AH, HV, and VA intervals were not affected. Sustained reciprocating tachycardia could be induced in the all patients. All slow pathways were successfully identified and ablated.
  
  
  CONCLUSIONS
  Propofol has no effect on the electrophysiological properties of the AV node conduction system. It is thus a suitable anesthetic agent for use in patients undergoing ablative procedures.
authors.affiliation: Institute of Cardiology of Rio Grande Do SUL/FUC, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, Brazil. pwar2002@terra.com.br
authors.forename: Paulo
authors.initials: P
authors.lastname: Warpechowski
authors.forename: Gustavo G
authors.initials: GG
authors.lastname: Lima
authors.forename: Cláudio M
authors.initials: CM
authors.lastname: Medeiros
authors.forename: Ari Tadeu L
authors.initials: AT
authors.lastname: Santos
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kruse
authors.forename: Marcelo H
authors.initials: MH
authors.lastname: Migloransa
authors.forename: Renato A K
authors.initials: RA
authors.lastname: Kalil
mesh_terms: D000328:Adult; D001283:Atrioventricular Node / Q000187:drug effects* / Q000503:physiopathology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D015742:Propofol / Q000008:administration & dosage*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol