Accelerated junctional rhythms during oral verapamil therapy

Schwartz, Janice B.; Jeang, Ming K.; Raizner, Albert E.; Griffin, Jerry C.; Wyndham, Christopher

doi:10.1016/0002-8703(84)90083-8

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…An accelerated junctional rhythm can be associated with myocardial infarction, heart surgery, digitalis intoxication, or sympathetic activation [2]. Therefore, it should be possible to exclude other factors in cases of intraoperative junctional rhythm.…”

Section: Discussionmentioning

confidence: 99%

“…An accelerated junctional rhythm usually has a rate between 60 and 100 beats/min and can result from a variety of conditions, including digoxin toxicity, open cardiac surgery, acute myocardial infarction, or isoproterenol infusion [2]. Volatile anesthetics can affect the sinoatrial (SA) node and may be associated with the development of junctional rhythm during surgery [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Junctional rhythm with severe hypotension following infiltration of lidocaine containing epinephrine during dental surgery

Jeon

Shim

Kim

2020

J Dent Anesth Pain Med

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We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%