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LETTER TO THE EDITOR

Desflurane's Effect on QTc Interval: Electrophysiological Mechanisms Need to Be Explored

Halil Yldrm, MD

Anesthesiology Department, Izmir Teaching Hospital, Izmir, Turkey, drhalilyildirim{at}hotmail.com

In Response:

We appreciate Dr. Venkatesan's acknowledgment of our work (1). QT interval prolongation is associated with life-threatening arrhythmias. Inhaled anesthetics prolong the QT interval (2) and can induce life-threatening arrhythmias in patients with prolonged QT interval (3).

We studied the effects of three inhaled anesthetics (sevoflurane, isoflurane, and desflurane) on QT interval, QTc interval, QT dispersion, and QTc dispersion (4). At the time we were unaware of any previous studies on the effect of desflurane on QT interval and were unaware of the continuing work by Owczuk et al. (5).

In our view, further clinical studies are needed to fully understand the arrhythmogenic properties of inhaled anesthetics.

References

1. Venkatesan T. Desflurane's effect on QTc interval: electrophysiological mechanisms need to be explored. Anesth Analg 2006;102:1592.[Free Full Text]
2. Schimeling WT, Warltier DC, McDonald DJ, et al. Prolongation of the QT interval by enflurane, isoflurane and halothane in humans. Anesth Analg 1991;72:137–44.[Web of Science][Medline]
3. Katz RI, Quijano I, Barcelon N, et al. Ventricular tachycardia during general anesthesia in a patient with congenital long QT syndrome. Can J Anaesth 2003;50:398–403.[Web of Science][Medline]
4. Yildirim H, Adanir T, Atay A, et al. The effects of sevoflurane, isoflurane and desflurane on QT interval of the ECG. Eur J Anaesthesiol 2004;21:566–70.[Web of Science][Medline]
5. Owczuk R, Wujtewicz MA, Sawicka W, et al. The influence of desflurane on QTc interval. Anesth Analg 2005;101:419–22.[Abstract/Free Full Text]

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