Abstract
The patient diagnosed as WPW syndrome, with atrial fibrillation and short refractory period of the accessory pathway, can be classified in a high risk group, because of high incidence of sudden death. Anesthetic manegement of the accessory pathway division on a 58 year old woman is presented. She had atrial fibrillation and reentrant tachyarrhythmia attack even during her sleep and ventricular fibrillation occurred when antiarrhythmic drugs therapy is interrupted for electrophysiological study, and she was diagnosed as high risk group of WPW syndrome.
The most important point of anesthetic manegement may be how to control reentrant tachyarrhythmia attack when antiarrhythmic drugs therapy is interrupted.
In this case, pentobarbital, morphine and scopolamine were selected as premedicant. Anesthesia was induced by fentanyl (0.01mg/kg) and diazepam 10mg, and was maintained with combinating fentanyl and nitrous oxide-oxygen-halothane.
Division of accessory pathway was performed uneventfully without disappearance of delta-wave during mapping.
