Tachycardia and General Anesthesia

Posted by doneuro @doneuro, Apr 26, 2019

Is it safe to have general anesthesia with a history of AV nodal reentrant tachachardia? I will be having a procedure (about 1 hour long)

Hi @doneuro,

Atrioventricular nodal reentry tachycardia (AVNRT) is the most common type of supraventricular tachycardia.
Though no surgical procedure is completely risk-free, the incidence of general anesthesia complications is relatively rare now. Most likely your doctors have or will be discussing your health history with the anesthesiologists. When patients who have tachycardia undergo a surgical procedure that requires general anesthesia, it is beneficial to have a cardiac anesthesiologist present (you might want to ask your doctor about that).
To avoid any complications of anesthesia many factors are taken into consideration – skill and knowledge of anesthetist/anesthesiologist, choice of sedative drugs, presurgery medications. https://www.mayoclinic.org/tests-procedures/anesthesia/about/pac-20384568

I encourage you to go through these articles which discuss the effect of anesthesia on the heart:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505762/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613596/

There are a few Connect members that I’d like to introduce you to. Meet @1997ta @guardian @cyndiblaw @sue225 @danab @dorothydavidson @aparr and Mentors @hopeful33250 @predictable. I’m hoping they will join in with their thoughts. May I ask what concerns you have, @doneuro?

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Hello @doneuro

I'm glad that @kanaazpereira, invited me to this discussion about tachycardia during general anesthesia. Her recommendation to request a cardiac anesthesiologist is good. I never thought of that myself. My problem with tachycardia during anesthesia happened during what is referred to as conscious sedation. It was not a lengthy surgery, 30 minutes or less. After that experience, I did, however, get a copy of the anesthesia report so that I would have a record of when the tachycardia began and what meds the anesthesiologist used to slow things down. I kept that report and whenever I'm going to a new hospital for any type of procedure, I take the report with me so that the anesthesiologist will have some knowledge of what could happen.

If I were you, I would bring with me any diagnostic reports that show your history of AV nodal reentrant tachycardia to the hospital and present them to the anesthesiologist on duty. It will prevent any surprises for the anesthesiologist and for you.

Do you have any other concerns you would like to address? When will you be having this procedure?

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Hello and thank you for your input. I will be having surgery at the end of the month, was told it would take 1 hour. Very nervous about this, so all input is greatly appreciated.

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@kanaazpereira

Hi @doneuro,

Atrioventricular nodal reentry tachycardia (AVNRT) is the most common type of supraventricular tachycardia.
Though no surgical procedure is completely risk-free, the incidence of general anesthesia complications is relatively rare now. Most likely your doctors have or will be discussing your health history with the anesthesiologists. When patients who have tachycardia undergo a surgical procedure that requires general anesthesia, it is beneficial to have a cardiac anesthesiologist present (you might want to ask your doctor about that).
To avoid any complications of anesthesia many factors are taken into consideration – skill and knowledge of anesthetist/anesthesiologist, choice of sedative drugs, presurgery medications. https://www.mayoclinic.org/tests-procedures/anesthesia/about/pac-20384568

I encourage you to go through these articles which discuss the effect of anesthesia on the heart:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505762/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613596/

There are a few Connect members that I’d like to introduce you to. Meet @1997ta @guardian @cyndiblaw @sue225 @danab @dorothydavidson @aparr and Mentors @hopeful33250 @predictable. I’m hoping they will join in with their thoughts. May I ask what concerns you have, @doneuro?

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Hello and thank you very much for this information.

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Hi @doneuro im not sure i can help in this area. I was unaware during my years of Arrythimias that general anesthesia was an issue. But all of my procedures we ablations or pacemaker installing so they were trying to cause arrythmias during the procedures. But during that time all i had were experts in the Tachacardia area. Mine problem area was Ventricular Tachacardia. I will say that the advice i read sounds logicial tho. Good luck and if i can help with any questions please feel free to ask.

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Thanks very much!

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@danab

Hi @doneuro im not sure i can help in this area. I was unaware during my years of Arrythimias that general anesthesia was an issue. But all of my procedures we ablations or pacemaker installing so they were trying to cause arrythmias during the procedures. But during that time all i had were experts in the Tachacardia area. Mine problem area was Ventricular Tachacardia. I will say that the advice i read sounds logicial tho. Good luck and if i can help with any questions please feel free to ask.

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I remember when I had just been diagnosed with ventricular tachycardia, my cardiologist expressed concern when I mentioned upcoming dental implant surgery. It would involve bone grafting and the dental surgeon recommended anaesthesia. The cardiologist wanted to know if an anaesthesist would be doing it. (No). In the end, I did not go ahead.
Then, about a year and a half ago, the private clinic that does scoping (gastroscopy) (in Canada) did not want me to do the procedure there (used propofol). Quite frankly, I felt safer having the gastroscopy done in a hospital setting. I get nervous before procedures and my heart rate went up and my blood pressure soared to 190 (cant remember over what). The nurses kept monitoring me and eventually I was wheeled in, given sedation (b.p. went down). You have to be careful with anaesthetic when dealing with ventricular tachycardia. Also, when at the dentist's office, there is one type of local freezing that makes your heart really race. On my chart, it days do not use.

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@sue225

I remember when I had just been diagnosed with ventricular tachycardia, my cardiologist expressed concern when I mentioned upcoming dental implant surgery. It would involve bone grafting and the dental surgeon recommended anaesthesia. The cardiologist wanted to know if an anaesthesist would be doing it. (No). In the end, I did not go ahead.
Then, about a year and a half ago, the private clinic that does scoping (gastroscopy) (in Canada) did not want me to do the procedure there (used propofol). Quite frankly, I felt safer having the gastroscopy done in a hospital setting. I get nervous before procedures and my heart rate went up and my blood pressure soared to 190 (cant remember over what). The nurses kept monitoring me and eventually I was wheeled in, given sedation (b.p. went down). You have to be careful with anaesthetic when dealing with ventricular tachycardia. Also, when at the dentist's office, there is one type of local freezing that makes your heart really race. On my chart, it days do not use.

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Well now that you mention it i did get dental implants to secure my lower denture. And i remember due to my VT condition the oral surgeon did not want to do general anesthesia and we did it with normal novicane. But it was a bit painful i never really knew why the surgeon was against general

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@danab

Well now that you mention it i did get dental implants to secure my lower denture. And i remember due to my VT condition the oral surgeon did not want to do general anesthesia and we did it with normal novicane. But it was a bit painful i never really knew why the surgeon was against general

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I have had prior dental implant surgeries prior before the v. tach diagnosis. One involved a bone graft. I chose to do all of them with only local freezing and it was fine.

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I think if the bone graft is taken from the hip, you need a general anaesthetic. As for the drugs used in dental procedures, I have always been given a non stimulating drug. It is short acting so the dentist or specialist has to be quick and has had to administer the drug many times over the course of the procedure.

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