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Heart Disease  (Expert Forum)
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Anesthesia and Arrhythmias
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Anesthesia and Arrhythmias

by Icaretolive, Jul 15, 2003 12:00AM
I am a forty-one year old female. I have been going to an Electrophysiolgist for the past ten years for arrhythmias. Tachycardia, pacs, pvc, ecotopic beats and various others. I am told that by heart starts beating from the bottom in my ventricles. I take the antiarrhythmic drug, Flecainide.

I recently went into the hospital for some minor surgery. The anesthesiologist had a very difficult time locating a vein to insert the IV line. He administered Nitrous Oxide to me for the sole purpose of dilating my veins because he couldn't insert the IV. I never was given Nitrous Oxide before in my life, which I have had many, many major surgeries, including spinal fusions. I went into Supra Ventricle Tachycardia. I was awake during this aweful experience because the IV still was not inserted into my hand or arm. The surgery was cancelled.

My question is....."Are anesthesiologist supposed to administer Nitrous Oxide to cardiac patients with arrhythmias??"

I am begging anyone who has ever gone through this aweful experience to please let me know?

Thank you in advance for any information ANYONE can give me!

Chelle

by CCF-M.D.-RCJ, Jul 16, 2003 12:00AM
Chelle,

I am not familiar with any known contraindication to using nitrous oxide in patients with arrhthymias, provided the patients otherwise have normal hearts.

I'm not sure of the purpose of your question, however.  Are you wanting to confront the anesthesiologist?  Do you want to warn others away from him?  Are you concerned that damage was done?

I can answer that although this experience sounds awful, no permanent damage would be likely to have occured.

Hope that helps.






Member Comments (6)

by Linda123, Jul 15, 2003 12:00AM
Hi, I have atrial tachycardia (which is either the same or very similar to SVT) and I don't know if this is the relevant to your particular problem but whenever I have an anesthetic it always sets it off.  I understand this happens because of the adrenaline in the shot which my a-tachy is very susceptible to.  I always ask for a non-adrenaline shot but even then the heart racing might occur.
Hope this is helpful to you.
Best Wishes, Linda

by katanos, Jul 15, 2003 12:00AM
There might in fact be some correlation, I know that my arrhythmias started after surgery I had in 1997. Right after surgery, recovering at home I had a severe bout of bradycardia and was severely diaphoretic. I briefly blacked out. Some could explain this as simply as a small excess of the anesthetic drugs being still present in my system..ok, but it does not explain my drop in HR to this day. Before the surgery constant HR of 74-78, to this day, my resting HR is 49-60 and constant PAC's and PVC's (I'm 36, in good shape no driking or smoking, BP is ok).
Just a little more info, I was given what is called a "cocktail" which is a combination of many drugs to sedate me including fentanyl, propanolol (something similar to this) and a few others- I don't have a list I just asked my doc in the operating room. I'm sure there are some people who have hypersensitivity or who are predisposed to problems with certain drug combinations, you will never know.

by spachic1, Jul 15, 2003 12:00AM
ok question and comment.
I have always been told that a slower resting heart rate is actually a great thing. I am athletic 37 and have been for years. I have a resting heart rate of 51 to 60 all day long. Its when I have panic or something that my rate goes up for a while.
If you have a resting heart rate of 70-80 I thought this was not as good. Am i wrong?
I don't know much about tachycardia and others but it must be awful to have to go through so much and keep calm. I have had pvc all my life but not in runs or days like now. It just developed recently. I have had tests and waiting to see the cardiologist next week. I will see then what they found.
At least theres lots of great tests now and great meds etc for people like us.
take care

by sheryl1945, Jul 17, 2003 12:00AM
To: Spachic1
I'm no doctor, but I understand that most athletes do have a lower heart rate, which is good.  I'm no athlete either, but when my heart started doing 120 at rest it needed to be slowed down.  I take 25 mg tenormin daily and it slows my heart down into the 80's.  A rapid heartbeat is very uncomfortable, so I hope you'll become comfortable with yours.  I get a lot of pac's/pvc's, but have been told they're harmless.  Oh, I almost forgot -- a cardiologist told me that walking regularly would also help to slow down my heart, and he was right.  I'm a "walker" and my heartbeat has changed drastically; it no longer races and is much more comfortable to live with.  Congrats on your slow heartbeat, enjoy!

by netrox, Jul 19, 2003 12:00AM
About athletes, this may surprise you:

"More than half of healthy professional football players may have abnormalities in the electrical activity of their hearts, US researchers report."

http://www.heartcenteronline.com/myheartdr/home/research-detail.cfm?reutersid=2864

"An irregular heartbeat frequently observed in trained athletes in the absence of cardiac abnormalities usually is benign and should not keep athletes from competing according to a new study.
...
Only 7 percent of the athletes had cardiac abnormalities and most of those belonged to the group with the most frequent tachycardias. The group of athletes experiencing the highest amount of tachycardias was excluded from competition. However, during a follow-up one of them had died while playing a field hockey game against medical advice. All the athletes in the low and moderate frequency groups survived.

According to the lead author of the study, Dr. Alessandro Biffi, "athletes with ventricular arrhythmias in the absence of heart disease should not be disqualified from competing in sports".

http://www.heartcenteronline.com/myheartdr/home/research-detail.cfm?reutersid=2849

-jeff
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