Ventricular tachycardia and acute heart failure induced by atropine in the treatment of bradycardia: A case report and literature review

Abstract

Rationale: Despite various advantages of laparoscopic surgical procedures, artificial pneumoperitoneum might lead to hemodynamic fluctuations including severe bradycardia and cardiac arrest. Atropine is usually proposed to treat intraoperative severe bradycardia ( < 40 beats per minute). However, atropine could induce ventricular arrhythmias, which might be life-threatening in severe case. Patient concerns: Here, we reported a 41-year-old female who was diagnosed with gallbladder polyps and was scheduled for laparoscopic cholecystectomy under general anesthesia. Diagnoses: Bradycardia occurred suddenly during the operation and atropine was injected intravenously. Eventually the patient developed ventricular tachycardia and acute heart failure. Interventions: We organized an urgent consultation and the patient was treated immediately. Outcomes: Fortunately, the patient experienced no complications after timely diagnosis and treatment. After 6 months of follow-up, her New York Heart Association classification was I with no complications. Lessons: This case highlighted that the administration of atropine to treat bradycardia may lead to ventricular tachycardia and acute heart failure, and anesthesiologists should remain vigilant to avoid potentially life-threatening consequences.

A portent of catastrophic carbon dioxide embolism in laparoscopic hepatectomy: A case report

“…[ 9 ] ETCO 2 monitoring is not very specific, and it may increase initially. [ 10 ] Moreover, the changes in ETCO 2 are rapid and sometimes of short duration; they could easily be missed in the operating theater. [ 11 ]…”