Accelerated idioventricular rhythm during spinal anesthesia for cesarean section

Giovanni Coven, Roberto Arpesella, Maria Ciceri, Ivano Preseglio, Anna Cardani

Research output: Contribution to journalArticlepeer-review


During cesarean section under regional anesthesia various anomalies of the electrocardiogram are reported such as bradycardia, supraventricular and ventricular premature beats, supraventricular paroxysmal tachicardia, S-T depression non-significant for myocardial ischemia and second degree atrioventricular block. We describe two cases of accelerated idioventricular rhythm in patients undergoing elective cesarean section with spinal anesthesia of which we have not found mention in the literature. This arrhythmia is not dangerous and does not usually evolve into ventricular fibrillation. During spinal anesthesia, however, it can exacerbate hypotension and, if misdiagnosed, a further administration of ephedrine can increase the duration of accelerated idioventricular rhythm. When necessary, for example in symptomatic hypotension or severe bradycardia, atropine is advised in order to inhibit vagal tone and increase the activity of the sino-atrial node, obtaining a pharmacological overdrive. This therapy is appropriate even if the frequency of the accelerated idioventricular rhythm is high.

Original languageEnglish
Pages (from-to)121-125
Number of pages5
JournalInternational Journal of Obstetric Anesthesia
Issue number2
Publication statusPublished - Apr 2003

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Psychology(all)


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