Occurrence of intermittent Wolff-Parkinson-White syndrome during intravenous sedation

Wakita, Ryo; Takahashi, Masato; Ohe, Chikako; Kohase, Hikaru; Umino, Masahiro

doi:10.1016/j.jclinane.2007.06.025

Cited by 12 publications

(7 citation statements)

References 25 publications

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“…Furthermore, propofol may improve cardiac conduction. After propofol injection, the delta wave of Wolff-Parkinson-White syndrome has been shown to disappear and the P-R interval to normalize, though the delta wave returned immediately after propofol discontinuation [7, 8] . The Q-T interval of long Q-T syndrome was shortened when propofol was used; therefore, propofol may have the potential to prevent episodes of VT that are due to Q-T interval dispersion [9, 10] .…”

Section: Antiarrhythmic Property Of Propofolmentioning

confidence: 99%

Propofol and arrhythmias: two sides of the coin

et al. 2011

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The hypnotic agent propofol is effective for the induction and maintenance of anesthesia. However, recent studies have shown that propofol administration is related to arrhythmias. Propofol displays both pro- and anti-arrhythmic effects in a concentration-dependent manner. Data indicate that propofol can convert supraventricular tachycardia and ventricular tachycardia and may inhibit the conduction system of the heart. The mechanism of the cardiac effects remains poorly defined and may involve ion channels, the autonomic nervous system and cardiac gap junctions. Specifically, sodium, calcium and potassium currents in cardiac cells are suppressed by clinically relevant concentrations of propofol. Propofol shortens the action potential duration (APD) but lessens the ischemia-induced decrease in the APD. Furthermore, propofol suppresses both sympathetic and parasympathetic tone and preserves gap junctions during ischemia. All of these effects cumulatively contribute to the antiarrhythmic and proarrhythmic properties of propofol.

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Section: Antiarrhythmic Property Of Propofolmentioning

confidence: 99%

Propofol and arrhythmias: two sides of the coin

et al. 2011

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“…The total search revealed 6366 articles on WPWS. The search yielded 24 cohorts with a preoperative or perioperative diagnosis of the WPWS in association with procedures of the head and neck/oral and maxillofacial region and have been summarized in Table 1 8–31 …”

Section: Resultsmentioning

confidence: 99%

Wolff–Parkinson–White syndrome: Review of published cases associated with head and neck/oral and maxillofacial procedures

et al. 2022

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Aim The objective of this article is to review the demographics, diagnostic criteria, etiopathogenesis, comorbidities and management of Wolff–Parkinson–White syndrome (WPWS). In addition, the relevant cardiovascular outcomes of published cases involving head and neck/oral and maxillofacial procedures were summarized. Materials and Methods A search of the PubMed database, restricted to human studies published in the English language literature, was performed from 1960 through July 2021 for articles. Results The search strategy yielded 24 patients, totalling 25 dates of treatment, with WPWS concordant with head and neck/oral and maxillofacial procedures, predominately involving biopsy, tumour resection and extractions; significantly, 5 of whom, experienced their first episode of WPWS while undergoing treatment of the head and neck. None of the procedures resulted in patient death. Conclusions Practitioners should be familiar with the clinical features of WPWS and be prepared to manage emergent cardiovascular deterioration. Electrocardiogram monitoring of this cohort is advised during head and neck/oral and maxillofacial surgical procedures, particularly involving general anaesthesia. Breakthrough episodes of WPWS may still occur in patients who have previously undergone cardioconversion.

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“…Moreover, preparation to perform electrical cardioversion in case of haemodynamic compromise or ventricular fibrillation also should be made. [8] Refractory arrhythmias under general anaesthesia has been managed with phenylephrine by acting directly to stimulate the arterial baroreceptors and hence vagal output. [9]…”

Section: Discussionmentioning

confidence: 99%