Anesthetic Management of a Patient With Catecholaminergic Polymorphic Ventricular Tachycardia

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disorder induced by adrenergic stress. Electrophysiologically, it is characterized by emotional stress- or exercise-induced bidirectional ventricular tachycardia that may result in cardiac arrest. Minimiz...

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Bibliographic Details
Published in:Anesthesia progress 2022-06, Vol.69 (2), p.24-29
Main Authors: Shionoya, Yoshiki, Hirayama, Kaoru, Saito, Kaho, Kawasaki, Eriko, Kantake, Yoko, Okamoto, Hazuki, Goi, Takahiro, Sunada, Katsuhisa, Nakamura, Kiminari
Format: Article
Language:English
Subjects:
Age
Airway management
Anesthesia
Anxiety
Blood
Cardiac arrhythmia
Cardiac stress tests
Case Reports
Catecholamines
Defibrillators
Electrocardiography
Exercise
Family medical history
Fear & phobias
Heart
Hospitals
Intravenous administration
Mutation
Patients
Physical fitness
Surgery
Tachycardia
Ventricle
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Summary:Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disorder induced by adrenergic stress. Electrophysiologically, it is characterized by emotional stress- or exercise-induced bidirectional ventricular tachycardia that may result in cardiac arrest. Minimizing perioperative stress is critical as it can reduce fatal arrhythmias in patients with CPVT. Dexmedetomidine (DEX), a centrally acting sympatholytic anesthetic agent, was used in the successful intravenous (IV) moderate sedation of a 27-year-old female patient with CPVT, a history of cardiac events, and significant dental fear and anxiety scheduled to undergo mandibular left third molar extraction. Oral surgery was successfully performed under DEX-based IV sedation to reduce stress, and no arrhythmias were observed. IV sedation with DEX provided a sympatholytic effect with respiratory and cardiovascular stability in this patient with CPVT who underwent oral surgery.
ISSN:0003-3006
1878-7177
DOI:10.2344/anpr-68-04-03