Alteration of fatal 1:1 conducted atrial flutter to less conducted ratio by landiolol infusion
| Autor: | Tomoko Arashi, Junko Takata, Tomoko Mae, Naoko Haruyama |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty medicine.medical_treatment Morpholines 030204 cardiovascular system & hematology Cardioversion Loading dose 03 medical and health sciences Electrocardiography Ventricular Dysfunction Left 0302 clinical medicine Internal medicine Atrial Fibrillation medicine Humans Urea 030212 general & internal medicine Aged 80 and over Ejection fraction medicine.diagnostic_test business.industry Atrial fibrillation Landiolol medicine.disease Anesthesiology and Pain Medicine Atrial Flutter Anesthesia Cardiology medicine.symptom business Atrial flutter medicine.drug |
| Zdroj: | Journal of anesthesia. 30(4) |
| ISSN: | 1438-8359 |
| Popis: | An 84-year-old male patient with a past history of atrial-flutter-fibrillation and dementia underwent an urgent femoral neck fracture surgery. Preoperative electrocardiography demonstrated atrial flutter (AFL) with ventricular conduction at a ratio of 2:1-4:1, and transthoracic echocardiography showed severe left ventricular dysfunction with Ejection Fraction of 14.6 %. Femoral nerve block and Lateral femoral cutaneous nerve block with sedation was planned for the surgery. Upon entry to the operating room, ECG showed 2:1 conducted AFL at the rate of 128 beats min(-1). Due to the stimulation of urethral catheter insertion, it has altered to 1:1 conducted AFL. Loading dose of landiolol hydrochloride 7.5 mg followed by 1.5-3 μg/kg/min continuous administration was given, which had decreased the conduction ratio to 2:1 without causing hypotension. A further episode of 1:1 conducted AFL occurred when the pin was inserted to the thighbone, which caused circulatory collapse. Additional bolus dose of landiolol immediately altered it to 2:1 before operating cardioversion and stabilized the hemodynamics. He maintained AFL with 2:1 conduction thereafter, and 1:1 conduction was never seen postoperatively even after discontinuation of landiolol. |
| Databáze: | OpenAIRE |
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