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Korean Journal of Anesthesiology 1999;37(6):1143-1148.
DOI: https://doi.org/10.4097/kjae.1999.37.6.1143   
Unexpected Intermittent Preexcitation Syndrome (WPW Type) in Patient with Ventricular Parasystole during General Anesthesia: A case report.
Yun Seok Jeon, Pyung Bok Lee, Kye Min Kim, Yong Seok Oh, Yun Shik Choi
1Department of Anesthesiology, Sogwipo Sacred Heart Hospital, Sogwipo, Korea.
2Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
3Department of Anesthesiology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea.
4Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
We report a case in which WPW (Wolff-Parkinson-White)-type preexcitation syndrome arose unexpectedly immediately after induction of general anesthesia on a 25-yr-old man who had another rare cardiac arrhythmia, parasystole. His preoperative ECG showed ventricular bigeminy and a delta wave was observed after induction of anesthesia with fentanyl, midazolam and propofol. Anesthesia was maintained with propofol, fentanyl and nitrous oxide. The intraoperative ECG showed varying and temporary responsiveness to drugs such as atropine, lidocaine and ephedrine. After we started to infuse the dobutamine, the delta wave, ventricular bigeminy disappeared on the intraoperative ECG. We should consider the influence of anesthesia-related agents on arrhythmia, and aim to prevent and manage tachyarrhythmias caused by this syndrome.
Key Words: Heart, arrhythmia; ventricular parasystole; preexcitation syndrome; Wolff-Parkinson-White syndrome


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