Journal article
Recognition and Treatment of Bradycardias and Atrioventricular Block
Anesthesiology clinics of North America, Vol.7(2), pp.373-400
06/1989
DOI: 10.1016/S0889-8537(21)00210-8
Abstract
There are several concerns when a patient with bradycardia or conduction abnormalities must undergo anesthesia and surgery. First is the possibility that the arrhythmia will worsen intraoperatively. A second concern is whether pharmacologic interventions would be effective if hemodynamic instability occurs. A third concern is whether a pacemaker should be placed preoperatively or whether standby facilities31,72 (external pacing)111 are sufficient. A knowledge of the site of the arrhythmia, its expected physiology and natural history can be of help to answer these concerns. Conduction disturbances high in the system (such as AV node) generally are benign since they do not progress to more severe conduction blockade, they respond to pharmacologic agents such as atropine and isoproterenol, and their escape pacemaker is fast enough to maintain hemodynamic stability. Disturbances lower in the system are rare, more pathologic, and frequently result in hemodynamic instability. The individual arrhythmias of sick sinus syndrome, first-degree, second-degree, and third-degree AV block have been discussed. It is hoped that this discussion will aid in the planning of a safe intraoperative course for patients with these disorders
Details
- Title: Subtitle
- Recognition and Treatment of Bradycardias and Atrioventricular Block
- Creators
- Alan F. Ross - University of IowaJames R. Martins - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Anesthesiology clinics of North America, Vol.7(2), pp.373-400
- DOI
- 10.1016/S0889-8537(21)00210-8
- ISSN
- 0889-8537
- eISSN
- 1558-4259
- Language
- English
- Date published
- 06/1989
- Academic Unit
- Anesthesia; Internal Medicine
- Record Identifier
- 9984295954802771
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