The treatments of perioperative vascular vagus reflex in CARTO guided radiofrequency ablation in the treatment of atrial arrhythmia / 重庆医学

Objective To investigate the effective therapic methods of the perioperative vasovagal reflex(RV)in patients with atrial arrhythmias(AAs)underwent by catheter ablation .Methods The clinical data in the patients with atrial arrhythmias(AAs) complicated by vasovagal reflex(RV)were retrospectively analyzed during the perioperative procedure of catheter ablation guided by three dimensional mapping system CARTO ;the clinical data were compared between patients with RV and without RV .Results A total of 535 patients with AAs underwent catheter ablation guided by three dimensional mapping system were collected from Janu‐ary 2010 to December 2012 ,and 35 cases of intraoperative RV were found .Compared by patients without RV ,the patients with RV had more elderly cases and the cases of hypertension ,coronary heart disease and diabetes .The RV occurrence was also associated with the fasting ,painful stimuli ,operation time and skill .Conclusion The perioperative RV often is occurred in the cases of high risk and have the precipitating factors ,and the good prognosis could be obtained by the detect and treatment as early as possible .

Oculocardiac Reflex during Strabismus Surgery

PURPOSE: To investigate the factors that influence development of oculocardiac reflex (OCR) during strabismus surgery and to discuss the preventive strategies. METHODS: We examined patients undergoing surgery for strabismus. One hundred and sixty extraocular muscles of 73 patients were operated and 114 extraocular muscles of 50 patients who were operated under general anesthesia were evaluated. We investigated the incidence of the OCR and subsequent postoperative vaso-vagal response (VVR). RESULTS: An overall rate of 74.0% of the patients and 53.8% of the muscles showed a positive OCR. Under general anesthesia, 74.0% of the patients and 50.9% of the muscles showed a positive OCR. There was a significant difference in the frequency of OCR between the medial rectus and the other muscles (p=0.009). The development of OCR is frequent during muscle traction in strabismus surgery. There was a significant association between positive OCR and subsequent postoperative VVR (p=0.039). CONCLUSIONS: The predictive factors of the OCR during strabismus surgery under general anesthesia were muscle type and procedure. Therefore cardiac monitoring during the operation is needed and gentle manipulation of the extraocular muscles is important especially when the medial rectus muscle. The estimation of OCR will be helpful for prevention of subsequent postoperative VVR.