Tachycardia-bradycardia syndrome in a patient with atrial fibrillation: a case report

• Published in: Korean journal of anesthesiology Vol. 68; no. 4; pp. 415 - 419
• Main Authors: Choi, Sung Hwan, Choi, Sung Lark, Lee, Bong Yeong, Jeong, Mi Ae
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Anesthesiologists 01.08.2015; Korean Society of Anesthesiologists; 대한마취통증의학회
• Subjects: artificial cardaic pacing; atrial fibrillation; Case Report; sick sinus syndrome; 마취과학; Artificial cardaic pacing; Atrial fibrillation; Sick sinus syndrome
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kjae.2015.68.4.415

An 83-year-old woman was scheduled for a second transurethral resection of a bladder tumor. The preoperative electrocardiogram evaluation revealed atrial fibrillation with a slow ventricular response (ventricular rate: 59 /min). After intravenous injection of 1% lidocaine 40 mg and propofol 60 mg, the ventricular rate increased to 113 beats/min and then fell rapidly to 27 beats/min. Blood pressure was 70/40 mmHg. Later an atrial fibrillation rhythm, with a ventricular rate of 100-130 beats/min, was observed together with a sinus pause and sinus rhythm with a ventricular rate of 40-50 beats/min. An external pacemaker was applied and set at 60 mA, 40 counts. After the patient regained consciousness, she presented an alert mental state and had no chest symptoms. She was discharged 2 weeks later without complications after insertion of a permanent pacemaker.