Anesthetic management of an AAI pacemaker patient with paroxysmal atrial fibrillation during colorectal surgery.

Journal Article

Perioperative management of patients with cardiac pacemakers may be challenging because of the increasing sophistication of these devices. We report a case of a patient with paroxysmal atrial fibrillation (PAF) and with a permanent AAIR (bipolar atrial-inhibited adaptive rate) pacemaker who suffered life-threatening episodes of arrhythmias during operation. The first episode was vagally induced PAF during bowel manipulation; the second, induced by the increased pacing threshold from the external electric cardioversion and hyperkalemia. Transcutaneous pacing provided cardiac pacing and stabilized the patient during the second episode. Thorough preoperative evaluation and prophylactic placement of temporary pacing or at least transcutaneous pacing are important for the avoidance and minimization of intraoperative complications in patients with sick sinus syndrome and with an AAI (atrial inhibited) pacemaker.

Full Text

Duke Authors

Cited Authors

  • Lin, J-A; Borel, CO; Wang, W-B; Wong, C-S; Yeh, C-C; Yang, C-P; Wu, C-T

Published Date

  • August 2006

Published In

Volume / Issue

  • 18 / 5

Start / End Page

  • 372 - 375

PubMed ID

  • 16905084

International Standard Serial Number (ISSN)

  • 0952-8180

Digital Object Identifier (DOI)

  • 10.1016/j.jclinane.2005.12.006

Language

  • eng

Conference Location

  • United States