Intraoperative diagnosis of rate-dependent bundle branch block
Rate-dependent left bundle branch block (LBBB) occasionally occurs during anaesthesia when the heart rate exceeds a critical value. While it is usually a benign disorder, it may mask the electrocardiographic manifestations of myocardial ischaemia and the ST-T wave pattern associated with LBBB may be...
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| Veröffentlicht in: | Canadian Anaesthetists' Society journal 1984-05, Vol.31 (3), p.302-306 |
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| container_issue | 3 |
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| container_title | Canadian Anaesthetists' Society journal |
| container_volume | 31 |
| creator | DOMINO, K. B LAMANTIA, K. L GEER, R. T KLINEBERG, P. L |
| description | Rate-dependent left bundle branch block (LBBB) occasionally occurs during anaesthesia when the heart rate exceeds a critical value. While it is usually a benign disorder, it may mask the electrocardiographic manifestations of myocardial ischaemia and the ST-T wave pattern associated with LBBB may be mistaken for those of ischaemia. This case report presents two cases in which rate-dependent LBBB was clearly documented during the perioperative period. It demonstrates the use of pharmacologic agents (e.g., atropine and neostigmine) and physiologic manipulations (e.g., carotid sinus massage) to alter the heart rate and confirm the diagnosis of benign rate-dependent LBBB in the operating room. These interventions should be used with caution in patients who have hypertension, angina, cerebrovascular, or AV node disease or in the setting of myocardial ischaemia or severe bundle branch disease. |
| doi_str_mv | 10.1007/BF03007895 |
| format | Article |
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These interventions should be used with caution in patients who have hypertension, angina, cerebrovascular, or AV node disease or in the setting of myocardial ischaemia or severe bundle branch disease.</description><identifier>ISSN: 0008-2856</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/BF03007895</identifier><identifier>PMID: 6722621</identifier><language>eng</language><publisher>Toronto, ON: Canadian Anaesthetists' Society</publisher><subject>Aged ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Atropine ; Biological and medical sciences ; Bundle-Branch Block - diagnosis ; Bundle-Branch Block - physiopathology ; Bundle-Branch Block - therapy ; Carotid Sinus ; Electrocardiography ; Female ; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. 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B</creatorcontrib><creatorcontrib>LAMANTIA, K. L</creatorcontrib><creatorcontrib>GEER, R. T</creatorcontrib><creatorcontrib>KLINEBERG, P. L</creatorcontrib><title>Intraoperative diagnosis of rate-dependent bundle branch block</title><title>Canadian Anaesthetists' Society journal</title><addtitle>Can Anaesth Soc J</addtitle><description>Rate-dependent left bundle branch block (LBBB) occasionally occurs during anaesthesia when the heart rate exceeds a critical value. While it is usually a benign disorder, it may mask the electrocardiographic manifestations of myocardial ischaemia and the ST-T wave pattern associated with LBBB may be mistaken for those of ischaemia. This case report presents two cases in which rate-dependent LBBB was clearly documented during the perioperative period. It demonstrates the use of pharmacologic agents (e.g., atropine and neostigmine) and physiologic manipulations (e.g., carotid sinus massage) to alter the heart rate and confirm the diagnosis of benign rate-dependent LBBB in the operating room. These interventions should be used with caution in patients who have hypertension, angina, cerebrovascular, or AV node disease or in the setting of myocardial ischaemia or severe bundle branch disease.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Atropine</subject><subject>Biological and medical sciences</subject><subject>Bundle-Branch Block - diagnosis</subject><subject>Bundle-Branch Block - physiopathology</subject><subject>Bundle-Branch Block - therapy</subject><subject>Carotid Sinus</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Intraoperative Period</subject><subject>Male</subject><subject>Massage</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><issn>0008-2856</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkM1Lw0AUxBdRaq1evAs5iAch-rKb_boIWqwWCl70HDa7bzWaJnU3EfzvTWmop4E3vxl4Q8h5BjcZgLx9WAAbVGl-QKZZrkWqtOSHZAoAKqWKi2NyEuMnAGMy5xMyEZJSQbMpuVs2XTDtBoPpqh9MXGXemzZWMWl9MtwwdbjBxmHTJWXfuBqTMpjGfiRl3dqvU3LkTR3xbNQZeVs8vs6f09XL03J-v0oty2WXSjBCeVo64am0VquM5dpz5iSq3AvqvTboGNcW81IA55ArBZYxwcFRrtmMXO16N6H97jF2xbqKFuvaNNj2sVAZiCEFA3i9A21oYwzoi02o1ib8FhkU27GK_7EG-GJs7cs1uj06rjP4l6NvojW13z5exT2mBVDJJPsDQsVvkA</recordid><startdate>198405</startdate><enddate>198405</enddate><creator>DOMINO, K. B</creator><creator>LAMANTIA, K. L</creator><creator>GEER, R. T</creator><creator>KLINEBERG, P. L</creator><general>Canadian Anaesthetists' Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198405</creationdate><title>Intraoperative diagnosis of rate-dependent bundle branch block</title><author>DOMINO, K. B ; LAMANTIA, K. L ; GEER, R. T ; KLINEBERG, P. L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-70a68f2bd6f27cc981349f53d7e84f62ff9aed359ce4b605504880c33650d2593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Atropine</topic><topic>Biological and medical sciences</topic><topic>Bundle-Branch Block - diagnosis</topic><topic>Bundle-Branch Block - physiopathology</topic><topic>Bundle-Branch Block - therapy</topic><topic>Carotid Sinus</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Intraoperative Period</topic><topic>Male</topic><topic>Massage</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DOMINO, K. B</creatorcontrib><creatorcontrib>LAMANTIA, K. L</creatorcontrib><creatorcontrib>GEER, R. T</creatorcontrib><creatorcontrib>KLINEBERG, P. 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L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraoperative diagnosis of rate-dependent bundle branch block</atitle><jtitle>Canadian Anaesthetists' Society journal</jtitle><addtitle>Can Anaesth Soc J</addtitle><date>1984-05</date><risdate>1984</risdate><volume>31</volume><issue>3</issue><spage>302</spage><epage>306</epage><pages>302-306</pages><issn>0008-2856</issn><eissn>1496-8975</eissn><abstract>Rate-dependent left bundle branch block (LBBB) occasionally occurs during anaesthesia when the heart rate exceeds a critical value. While it is usually a benign disorder, it may mask the electrocardiographic manifestations of myocardial ischaemia and the ST-T wave pattern associated with LBBB may be mistaken for those of ischaemia. This case report presents two cases in which rate-dependent LBBB was clearly documented during the perioperative period. It demonstrates the use of pharmacologic agents (e.g., atropine and neostigmine) and physiologic manipulations (e.g., carotid sinus massage) to alter the heart rate and confirm the diagnosis of benign rate-dependent LBBB in the operating room. These interventions should be used with caution in patients who have hypertension, angina, cerebrovascular, or AV node disease or in the setting of myocardial ischaemia or severe bundle branch disease.</abstract><cop>Toronto, ON</cop><pub>Canadian Anaesthetists' Society</pub><pmid>6722621</pmid><doi>10.1007/BF03007895</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0008-2856 |
| ispartof | Canadian Anaesthetists' Society journal, 1984-05, Vol.31 (3), p.302-306 |
| issn | 0008-2856 1496-8975 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Atropine Biological and medical sciences Bundle-Branch Block - diagnosis Bundle-Branch Block - physiopathology Bundle-Branch Block - therapy Carotid Sinus Electrocardiography Female General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Heart Rate Humans Intraoperative Period Male Massage Medical sciences Middle Aged |
| title | Intraoperative diagnosis of rate-dependent bundle branch block |
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