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- Title
Second-degree atrioventricular block induced by electrical stimulation of transcranial motor-evoked potential: a case report.
- Authors
Murakami, Toru; Tanaka, Satoshi; Tanaka, Ryusuke; Ito, Mariko; Ishida, Takashi; Kawamata, Mikito
- Abstract
Background: Although several complications of transcranial motor-evoked potentials (Tc-MEPs) have been reported, reports of arrhythmias during Tc-MEP are very rare. Case presentation: A 71-year-old woman underwent transforaminal lumbar interbody fusion under general anesthesia, with intraoperative Tc-MEP monitoring. Preoperative electrocardiography showed an incomplete right bundle branch block but no cardiovascular events in her life. After induction of anesthesia, Tc-MEP was recorded prior to the surgery. During the Tc-MEP monitoring, electrocardiography and arterial blood pressure showed a second-degree atrioventricular block, but it improved rapidly at the end of the stimulation, and the patient was hemodynamically stable. Tc-MEP was recorded seven times during surgery; the incidence of P waves without QRS complexes was significantly higher than before stimulation. The surgery was uneventful, and she was discharged eight days postoperatively without complications. Conclusions: Our case suggests that electrical stimulation for Tc-MEP can cause arrhythmia. Electrocardiography and blood pressure must be closely monitored during Tc-MEP monitoring.
- Subjects
EVOKED potentials (Electrophysiology); ELECTRIC stimulation; BUNDLE-branch block; ARRHYTHMIA; BLOOD pressure; INTRAOPERATIVE monitoring; ELECTRICAL injuries
- Publication
JA Clinical Reports, 2024, Vol 10, Issue 1, p1
- ISSN
2363-9024
- Publication type
Case Study
- DOI
10.1186/s40981-024-00722-3