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Spontaneous Remission Of Left Bundle Branch Block Immediately After Denitrogenation With Inhalation Of 100% Oxygen Prior To Anesthetic Induction

Ting et al., 2009Other/Unknown

Ting, P. C., Lin, T. S., Yang, M. W., & Ho, A. C. (2010). spontaneous remission of left bundle branch block immediately after denitrogenation with inhalation of 100% oxygen prior to anesthetic induction. Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists, 48(3), 140–144. https://doi.org/10.1016/S1875-4597(10)60046-X

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Abstract

Complete left bundle branch blocks have focused our attention, primarily because they are a sign predictive of mortality and a predictor of coexisting cardiovascular disease. Left bundle branch block (LBBB) is usually permanent but may occur transiently or intermittently. Spontaneous remission of LBBB rarely occurs during anesthesia. We present two patients in whom chronic LBBB reverted to normal sinus rhythm shortly following denitrogenation with inhalation of 100% oxygen during induction of anesthesia.

Case Details

Disease Location

Heart

Personal Characteristics

56 years old male. Heavy smoker (1 pack of cigarrretes for 35 years)

Clinical Characteristics

Patient undergoing for a right tympanoplasty for chronic otitis media. No signs of cardiovascular disease. Complete left bundle branch block diagnosed (clbb)

Remission Characteristics

While patient (1) was denitrogenized with oxygen, the clbb suddenly converighted to normal sinus rhythm.

Treatment & Mechanisms

Proposed Remission Mechanisms

Oxygen supplement had quenched the increased myocardial oxygen demand state which the chronic lbbb preconditioned

Clinical Treatment

Aspirin 100mg, isosorbide monthsonitrate 60mg and rosuvastatin 10mg per day

Non-Clinical Treatment

Oxygen

Additional Notes

Remission occurs only during 100% oxygen administration