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KMID : 0356920150680040415
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Korean Journal of Anesthesiology
2015 Volume.68 No. 4 p.415 ~ p.419
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Tachycardia-bradycardia syndrome in a patient with atrial fibrillation
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Choi Sung-Hwan
Choi Sung-Lark
Lee Bong-Yeong
Jeong Mi-Ae
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Abstract
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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.
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KEYWORD
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Artificial cardaic pacing, Atrial fibrillation, Sick sinus syndrome
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