Cardiac arrhythmias. Frequency during fiberoptic bronchoscopy and correlation with hypoxemia

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Abstract
To evaluate the occurrence of ECG abnormalities during fiberoptic bronchoscopy in relation to specific stages of the procedure and to hypoxemia, 50 hospitalized patients aged 53 .+-. 18 yr were studied who were undergoing bronchoscopy by continuously monitoring cardiac rhythm with a continuous 2-channel ECG recorder and O2 saturation by using ear oximetry. Major disturbances of cardiac rhythm (i.e., atrial, ventricular or both) developed in 20 (40%) patients. Ventricular arrhythmias were recorded in 10 patients (20%) and occurred with greatest frequency during passage of the bronchscope through the vocal cords in 5 of these patients. Atrial arrhythmias were detected in 16 patients (32%), but their occurrence did not correlate closely with any 1 stage of the procedure. Arrhythmias were most frequent in association with periods of maximum O2 desaturation in 12 of these 20 patients. O2 desaturation persisted for greater than 1 h after bronchoscopy in 34 (68%) of 50 subjects. Notably, no correlation was observed between the frequency of arrhythmias during bronchoscopy and patients'' age, sex, prior medications, or preexisting cardiac or pulmonary disorders. In no case was an ECG abnormality associated with adverse clinical sequelae.