SEVOFLURANE HAS NO ELECTROPHYSIOLOGICAL EFFECTS DURING RECIPROCATING TACHYCARDIA IN WOLFF-PARKINSON-WHITE (WPW) PATIENTS

Abstract

S101 Inducing reciprocating tachycardia (RT) is a useful technique to demonstrate the anatomic location and characteristics of accessory pathways in patients with WPW syndrome. Sevoflurane has been shown not to have any effect on the accessory pathway during antegrade or retrograde conduction [1], yet, the effects on RT is unknown. METHODS: With IRB approval and written consent, 15 WPW patients were studied, and RT was induced in 8 patients. During alfentanil/midazolam/vecuronium anesthesia, RT was induced and the following parameters measured: shortest cycle length (SCL), atrial-His (AH), His-ventricular (HV) and ventriculoatrial (VA) intervals. Alfentanil/midazolam administration was then discontinued and sevoflurane was administered at 1 MAC (2% end-tidal) and the study was repeated. Wilcoxon Signed Rank test compared the measured parameters prior to and during sevoflurane administration. P<0.05 was considered significant. Values are Mean +/- SD. RESULTS: Sevoflurane had no statistically significant effect on any of the measured parameters of RT. (Table 1)Table 1CONCLUSIONS: 1) There is no evidence that sevoflurane alters the electrophysiological characteristics of RT in WPW patients and 2) sevoflurane is a suitable anesthetic agent for mapping and subsequent ablation of accessory pathways. GRANT SUPPORT: ABBOTT LABORATORIES