Intravenous propofol shortens sinus cycle length and facilitates atrioventricular nodal conduction without interfering with radiofrequency catheter ablation in patients with tachyarrhythmia

Background. Propofol is now widely used as an intravenous anesthetic. The present study was performed to determine the effects of propofol on cardiac electrophysiologic properties and radiofrequency catheter ablation (RFCA) procedure in patients with tachyarrhythmia. Methods. Twenty-one were included, all consecutive patients undergoing RFCA for various tachyarrhythmias, including atrioventricular nodal reentrant tachycardia in 7, atrioventricular reciprocating tachycardia in 13 (4 with manifest and, 9 with concealed, accessory pathway) and idiopathic left ventricular tachycardia in 1. Continuous infusion, without loading, of propofol at 100 to 120 μg/kg/minute introduced smooth general anesthesia and stable 94-99% oxygen saturation without artificial ventilation. The electrophysiologic properties and the tachycardia inducibility were measured before and during propofol infusion. RFCA was then performed. Results. During propofol infusion, there was a significantly shorter sinus cycle length when compared to that before propofol infusion. The atrioventricular nodal conduction, both antegrade and retrograde, were facilitated. These changes were associated with a reduction of systolic, diastolic and mean arterial blood pressure. The accessory pathway effective refractory period, as well as the sinus node recovery time, atrial effective refractory period, ventricular effective refractory period were not significantly changed. All the tachycardias remained inducible during propofol infusion. RFCA was successfully performed in all patients. Conclusion. Propofol infusion increased sinus heart rate and facilitated atrioventricular nodal conduction. All the tachyarrhythmias remained inducible after propofol infusion, and the RFCA were performed smoothly or without may active effect.