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Arrhythmia during Extracorporeal Shock Wave Lithotripsy
Author(s) -
ZENG Z. R.,
LINDSTEDT E.,
ROIJER A.,
OLSSON S. B.
Publication year - 1993
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1993.tb15871.x
Subject(s) - extracorporeal shock wave lithotripsy , medicine , shock wave , shock (circulatory) , lithotripsy , computer science , physics , mechanics , surgery
Summary A prospective study of arrhythmia during extracorporeal shock wave lithotripsy (ESWL) was performed in 50 patients, using an EDAP LT01 piezoelectric lithotriptor. The 12‐lead standard ECG was recorded continuously for 10 min before and during treatment. One or more atrial and/or ventricular ectopic beats occurred during ESWL in 15 cases (30%). The occurrence of arrhythmia was similar during right‐sided and left‐sided treatment. One patient developed multifocal ventricular premature beats and ventricular bigeminy; another had cardiac arrest for 13.5 s. It was found that various irregularities of the heart rhythm can be caused even by treatment with a lithotriptor using piezoelectric energy to create the shock wave. No evidence was found, however, that the shock wave itself rather than vagal activation and the action of sedo‐analgesia was the cause of the arrhythmia. For patients with severe underlying heart disease and a history of complex arrhythmia, we suggest that the ECG be monitored during treatment. In other cases, we have found continuous monitoring of oxygen saturation and pulse rate with a pulse oxymeter to be perfectly reliable for raising the alarm when depression of respiration and vaso‐vagal reactions occur.