Dysrhythmias under General Anesthesia and Their Management

  • Zahid Hussain Khan Mail Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Ali Movafegh Department of Anesthesiology and Critical Care, Dr Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Hussain Kareem Abed Ali Department of Anesthesia, School of Allied Medical Sciences, International Campus, Tehran University of Medical Sciences, Tehran, Iran.
Anesthesia, Cardiac arrhythmias


Cardiac arrhythmias during anesthesia are common and almost benign, with the incidence ranging from 60 to 90%. Arrhythmias are one of several significant predictors for severe cardiovascular outcomes. It is essential, therefore, for the anesthetist to evaluate patients at risk preoperatively with a careful history and to have an appropriate knowledge concerning the etiology, electrophysiology, diagnosis, drug effects and treatment of arrhythmias.


Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof EL, Fleischmann KE, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines on perioperative cardiovascular evaluation for noncardiac surgery) developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery.Am J Cardiol. 2007;50(17):e159-e242.

Group PS. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. The Lancet. 2008;371(9627):1839-47.

Amar D, Zhang H, Heerdt PM, Park B, Fleisher M, Thaler HT. Statin use is associated with a reduction in atrial fibrillation after noncardiac thoracic surgery independent of C-reactive protein. Chest. 2005;128(5):3421-7.

Little JW, Falace D, Miller C, Rhodus NL. Dental Management of the Medically Compromised Patient-E-Book: Elsevier Health Sciences; 2012.

Katz RL, Bigger JT. Cardiac arrhythmias during anesthesia and operation. Anesthesiology: Journal the American Society of Anesthesiologists. 1970;33(2):193-213.

Kishnani PS, Steiner RD, Bali D, Berger K, Byrne BJ, Case L, et al. Pompe disease diagnosis and management guideline. Genetics in Medicine. 2006;8(5):267.

Packer M, Carver JR, Rodeheffer RJ, Ivanhoe RJ, DiBianco R, Zeldis SM, et al. Effect of oral milrinone on mortality in severe chronic heart failure. New England Journal Medicine. 1991;325(21):1468-75.

Opie LH, Nathan D, Lubbe WF. Biochemical aspects of arrhythmogenesis and ventricular fibrillation. The J Cardiology. 1979;43(1):131-48.

Nattel S. New ideas about atrial fibrillation 50 years on. Nature. 2002;415(6868):219-26.

Kucia A, Quinn T. Acute cardiac care: a practical guide for nurses: John Wiley & Sons; 2013.

Karpawich PP, Pettersen MD, Gupta P, Shah N. Infants and children with tachycardia: natural history and drug administration. Current Pharmaceutical Design. 2008;14(8):743-52.

Lorentz MN, ใ o Vianna BSB. Cardiac dysrhythmias and anesthesia. Brazilian Journal of Anesthesiology. 2011;61(6):798-813.

Macpherson DS. Preoperative laboratory testing: Should any tests be. Medical Clinics of North America. 1993;77(2):289-308.

Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal. 2010;31(19):2369-429.

Dickstein K, Cohen‐Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole‐Wilson PA, et al. ESC guidelines for the diagnosis and treatment of acute and chronic Heart Failure 2008. European Journal heart failure. 2008;10(10):933-89.

Crawford RS. Health beliefs related to physical activity in patients with implantable cardioverter defibrillators: The University of Arizona; 2013.

Malinow AM, Ostheimer GW. Anesthesia for the high-risk parturient. Obstetrics & Gynecology. 1987;69(6):951-64.

Wann LS, Curtis AB, January CT, Ellenbogen KA, Lowe JE, Estes NM, et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline). Circulation. 2010:CIR. 0b013e3181fa3cf4.

Kuner J, Enescu V, Utsu F, Boszormenyi E, Bernstein H, Corday E. Cardiac arrhythmias during anesthesia. Diseases of the Chest. 1967;52(5):580-7.

Cosío FG, Palacios J, Pastor A, Núñez A. The electrocardiogram. The ESC Textbook of Cardiovascular Medicine. 2009:29.

Feihl F, Perret C. Permissive hypercapnia. How permissive should we be?Am J resp Crit Med. 1994;150(6):1722-37.

Morrow DH, Logic JR. Management of cardiac arrhythmias during anesthesia. Anesth & Analg. 1969;48(5):748-54.

How to Cite
Khan Z, Movafegh A, Abed Ali H. Dysrhythmias under General Anesthesia and Their Management. Arch Anesth & Crit Care. 5(3):104-6.
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