- 期刊
Desflurane Inhibits U Wave in Electrocardiogram
Desflurane抑制心電圖的U波
摘要
Background: Volatile anesthetics inhibit cardiac transmembrane ionic currents and intracellular ionic activity and exert antiarrhythmic actions. Among electrocardiogram (ECG) waveforms, the effect of volatile anesthetics on U wave has never been studied. The aim of the present observational study was to evaluate the possible effect of desflurane on U wave in anesthetized patients. Methods: Pen-operative ECG tracings (lead Ⅱ) were recorded and analyzed from 24 gynecologic patients (American Society of Anesthesiologists (ASA), class 1). Anesthesia was routinely induced with thiopental, fentanyl and succinylcholine and maintained with desflurane (1 to 1.5 minimal alveolar concentration (MAC)) and O2. U wave amplitude (U(subscript amp) was manually measured from amplified ECG records. Results: Discernible U wave in 24 patients varied in amplitude (64±24μV). U wave was three times larger when heart rate increased to maximum during tracheal intubation. Similarly, U(subscript amp) was augmented (285%±58% of the control) in extrasystolic beats elicited by tracheal intubation. Desflurane (1 to 1.5 MAC) significantly and reversibly suppressed U(subscript amp)(a decrease by 60±24μV, n=24, p＜0.05). Conclusions: The suppressive effect of desflurane on U(subscript amp) might be explained by its inhibitory effects on transmembrane ionic currents, intracellular calcium load and delayed afterdepolarizations. Our results support a contributory role of afterpotentials in the genesis of U wave.
並列摘要
Background: Volatile anesthetics inhibit cardiac transmembrane ionic currents and intracellular ionic activity and exert antiarrhythmic actions. Among electrocardiogram (ECG) waveforms, the effect of volatile anesthetics on U wave has never been studied. The aim of the present observational study was to evaluate the possible effect of desflurane on U wave in anesthetized patients. Methods: Pen-operative ECG tracings (lead Ⅱ) were recorded and analyzed from 24 gynecologic patients (American Society of Anesthesiologists (ASA), class 1). Anesthesia was routinely induced with thiopental, fentanyl and succinylcholine and maintained with desflurane (1 to 1.5 minimal alveolar concentration (MAC)) and O2. U wave amplitude (U(subscript amp) was manually measured from amplified ECG records. Results: Discernible U wave in 24 patients varied in amplitude (64±24μV). U wave was three times larger when heart rate increased to maximum during tracheal intubation. Similarly, U(subscript amp) was augmented (285%±58% of the control) in extrasystolic beats elicited by tracheal intubation. Desflurane (1 to 1.5 MAC) significantly and reversibly suppressed U(subscript amp)(a decrease by 60±24μV, n=24, p＜0.05). Conclusions: The suppressive effect of desflurane on U(subscript amp) might be explained by its inhibitory effects on transmembrane ionic currents, intracellular calcium load and delayed afterdepolarizations. Our results support a contributory role of afterpotentials in the genesis of U wave.
延伸閱讀
- Chen, H. D., Feng, C. C., Yang, K. T., & Hung, G. U. (2007). 以壓力－休息鉈－201門控心肌灌注造影評估Dipyridamole對左心室功能的影響. 核子醫學雜誌, 20(3), 129-135. https://doi.org/10.6332/ANMS.2003.002
- 林霈、劉嚴文、蔡惟全（2022）。斑點追蹤心臟超音波評估左心室收縮功能的新進展。內科學誌，33(3)，169-177。https://doi.org/10.6314/JIMT.202206_33(3).01
- Chu, C. S., Lee, K. T., Cheng, K. H., Lin, T. H., Lee, M. Y., Voon, W. C., Sheu, S. H., & Lai, W. T. (2007). Verapamil及Procainamide對於人體心房組織短期快速電刺激所誘發的電氣重塑效應之影響. The Kaohsiung Journal of Medical Sciences, 23(12), 599-610. https://www.airitilibrary.com/Article/Detail?DocID=02575655-200712-23-12-599-610-a
- Hsiung, M. C., Ding, Y. A., Hsu, T. L., Chen, C. C., Wang, D. J., Shieh, S. M., & Chiang, B. N. (1988). 利用彩色杜卜勒超音波偵測心臟舒張期時房室瓣逆流. Journal of Medical Sciences, 8(6), 377-385. https://www.airitilibrary.com/Article/Detail?DocID=10114564-198801-201401100001-201401100001-377-385
- Tsai, M. Y. (2017). 基於壓縮分析之有效心律不整偵測機制於遠程心電圖監護系統 [master's thesis, National Taiwan University]. Airiti Library. https://doi.org/10.6342/NTU201701974