Ventricular tachycardia observed during cesarean section in a patient without structural cardiac disease

Nakanishi, Mika; Masumo, Kaoru; Oota, Takako; Kato, Takeshi; Imanishi, Toshio

doi:10.1186/s40981-015-0019-0

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…The subsequent administration of ergometrine potentially provided a trigger for increased vagal output. This suggested mechanism concurs with the mechanism suggested in the literature for other arrhythmias in the setting of oxytocin and ergometrine administration 18 21 22 25…”

Section: Discussionsupporting

confidence: 88%

“…Arrhythmias are also a recognised complication of ergometrine 16 17. A case of ventricular tachycardia during caesarean section precipitated by ergometrine has previously been described 18. Oxytocin has been reported to have an antiarrhythmic effect,19 20 but it has also been reported to prolong the QTc (the corrected QT interval) 21.…”

Section: Discussionmentioning

confidence: 99%

“…Ergometrine can cause bradycardia, increased vagal tone, or vasospasm 26 27. Vasospasm caused by ergometrine can manifest as coronary vasospasm with ST segment changes 18 28. In the peripartum setting, early research demonstrated a strong vagal effect of ergometrine administered via the intravenous route, where 12 of 100 patients developed sinoatrial node block 17.…”

Section: Discussionmentioning

confidence: 99%

“…Sinoatrial node block can predispose the patient to escape rhythms, such as AF or junctional rhythm. Other cardiac side effects of ergometrine include atrioventricular node block, premature ventricular contractions and ventricular tachycardia 18 26 27…”

Section: Discussionmentioning

confidence: 99%

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Ergometrine-induced atrial fibrillation at caesarean section

Birch¹,

2019

BMJ Case Rep

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A 36-year-old woman with a history of one previous caesarean section presented to the birthing suite of a regional hospital with spontaneous rupture of membranes at 39+2/40 weeks. Syntocinon was administered to initiate uterine contractions in the absence of labour, as the patient desired vaginal birth. A caesarean section was subsequently indicated and ergometrine was administered for uterine atony. The patient immediately developed atrial fibrillation (AF). AF is the most common sustained arrhythmia in the general population, but is rare in the obstetric population. AF occurring in an intrapartum setting following the administration of syntocinon and ergometrine, is not documented in the literature. We suggest the initiation of paroxysmal AF was precipitated by an abrupt alteration in autonomic tone caused by administration of syntocinon followed by ergometrine.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ergometrine-induced atrial fibrillation at caesarean section

Birch¹,

2019

BMJ Case Rep

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Miscellaneous Hormones

McCafferty¹,

Fawzy²

2017

Side Effects of Drugs Annual

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Ventricular Tachycardia Following Ephedrine During Dexmedetomidine Dental Procedural Sedation

Abe,

Suzuki,

Hamamura

et al. 2023

Anesthesia Progress

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We present the case of a 46-year-old man who received ephedrine for hypotension after surgery for a mandibular lesion under intravenous (IV) moderate sedation with dexmedetomidine (DEX) and experienced transient ventricular tachycardia (VT). The patient was scheduled to have cystectomy and multiple apicoectomies for the mandibular periapical infection and the simple bone cyst. Other than obesity, snoring, and a nonalcoholic fatty liver, he denied any other significant medical history, medications, or allergies. The surgery was successful; however, his blood pressure dropped after stopping the DEX infusion. Ephedrine was administered IV several times, which resulted in the onset of VT on the electrocardiogram (ECG). His blood pressure could not be measured at the time, but he was able to respond and breathe independently. A defibrillator was immediately made available. The ECG revealed a spontaneous transition from VT to atrial fibrillation with ST depression. Because he was unable to revert to a normal sinus rhythm, the patient was transferred to a general hospital, where he underwent additional testing. No abnormalities were observed in his heart or brain. After DEX administration, its long-lasting alpha-2 adrenoceptor agonist effects can cause vasodilation and inhibition of sympathetic activity, leading to hypotension in some patients. Should that occur, ephedrine can be used to increase blood pressure, but it may also provoke transient coronary artery spasms and lead to VT. Consequently, extreme caution should be exercised in patients who develop hypotension following DEX administration. We also recognize the significance of regular training sessions, such as advanced cardiac life support programs.

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Ventricular tachycardia observed during cesarean section in a patient without structural cardiac disease

Cited by 3 publications

References 9 publications

Ergometrine-induced atrial fibrillation at caesarean section

Ergometrine-induced atrial fibrillation at caesarean section

Miscellaneous Hormones

Ventricular Tachycardia Following Ephedrine During Dexmedetomidine Dental Procedural Sedation

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