title: Xenon does not increase heart rate-corrected cardiac QT interval in volunteers and in patients free of cardiovascular disease.
abstract: BACKGROUND
  Impaired cardiac repolarization, indicated by prolonged QT interval, may cause critical ventricular arrhythmias. Many anesthetics increase the QT interval by blockade of rapidly acting potassium rectifier channels. Although xenon does not affect these channels in isolated cardiomyocytes, the authors hypothesized that xenon increases the QT interval by direct and/or indirect sympathomimetic effects. Thus, the authors tested the hypothesis that xenon alters the heart rate-corrected cardiac QT (QTc) interval in anesthetic concentrations.
  
  
  METHODS
  The effect of xenon on the QTc interval was evaluated in eight healthy volunteers and in 35 patients undergoing abdominal or trauma surgery. The QTc interval was recorded on subjects in awake state, after their denitrogenation, and during xenon monoanesthesia (FetXe > 0.65). In patients, the QTc interval was recorded while awake, after anesthesia induction with propofol and remifentanil, and during steady state of xenon/remifentanil anesthesia (FetXe > 0.65). The QTc interval was determined from three consecutive cardiac intervals on electrocardiogram printouts in a blinded manner and corrected with Bazett formula.
  
  
  RESULTS
  In healthy volunteers, xenon did not alter the QTc interval (mean difference: +0.11 ms [95% CI, -22.4 to 22.7]). In patients, after anesthesia induction with propofol/remifentanil, no alteration of QTc interval was noted. After propofol was replaced with xenon, the QTc interval remained unaffected (417 ± 32 ms vs. awake: 414 ± 25 ms) with a mean difference of 4.4 ms (95% CI, -4.6 to 13.5).
  
  
  CONCLUSIONS
  Xenon monoanesthesia in healthy volunteers and xenon/remifentanil anesthesia in patients without clinically relevant cardiovascular disease do not increase QTc interval.
authors.affiliation: From the Department of Anesthesiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany (M.N., M.S.S., C.K., S.B., R.W., P.R., P.K.); and Department of Anesthesiology and Intensive Care Medicine, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany (M.R.-H.).
authors.forename: Martin
authors.initials: M
authors.lastname: Neukirchen
authors.forename: Maximilian S
authors.initials: MS
authors.lastname: Schaefer
authors.forename: Carolin
authors.initials: C
authors.lastname: Kern
authors.forename: Sarah
authors.initials: S
authors.lastname: Brett
authors.forename: Robert
authors.initials: R
authors.lastname: Werdehausen
authors.forename: Philipp
authors.initials: P
authors.lastname: Rellecke
authors.forename: Matthias
authors.initials: M
authors.lastname: Reyle-Hahn
authors.forename: Peter
authors.initials: P
authors.lastname: Kienbaum
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D002318:Cardiovascular Diseases; D015331:Cohort Studies; D005260:Female; D064368:Healthy Volunteers; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D014978:Xenon / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D014978:Xenon