Anesthetic management of an AAI pacemaker patient with paroxysmal atrial fibrillation during colorectal surgery

Jui An Lin, Cecil O. Borel, Wen Been Wang, Chih Shung Wong, Chun Chang Yeh, Chih Ping Yang, Ching Tang Wu

Research output: Contribution to journalArticle

3 Citations (Scopus)


Perioperative management of patients with cardiac pacemakers may be challenging because of the increasing sophistication of these devices. We report a case of a patient with paroxysmal atrial fibrillation (PAF) and with a permanent AAIR (bipolar atrial-inhibited adaptive rate) pacemaker who suffered life-threatening episodes of arrhythmias during operation. The first episode was vagally induced PAF during bowel manipulation; the second, induced by the increased pacing threshold from the external electric cardioversion and hyperkalemia. Transcutaneous pacing provided cardiac pacing and stabilized the patient during the second episode. Thorough preoperative evaluation and prophylactic placement of temporary pacing or at least transcutaneous pacing are important for the avoidance and minimization of intraoperative complications in patients with sick sinus syndrome and with an AAI (atrial inhibited) pacemaker.

Original languageEnglish
Pages (from-to)372-375
Number of pages4
JournalJournal of Clinical Anesthesia
Issue number5
Publication statusPublished - Aug 2006
Externally publishedYes



  • AAI
  • Anesthesia
  • Arrhythmia
  • Cardiac arrest
  • Complication
  • general anesthesia
  • Pacemaker
  • pacemaker malfunction
  • paroxysmal atrial fibrillation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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