Heart Rate Variability during a Procedure Involving Electrochemotherapy of Metastases in Liver - A Case Report

摘要

Electrochemotherapy (ECT) is an effective and safe method for local treatment of tumors. Bleomycin administration, delivery of high voltage electroporation (EP) pulses and surgery procedure may all lead to changes in heart rate variability (HRV). HRV is a variation of the period between consecutive normal heartbeats (NN intervals) over time. We report on the preliminary findings about the influence of intraabdominal ECT of liver tumors on electrocardiogram (ECG) and HRV of one patient. For this purpose, the ECGs recorded before, during and after surgical procedure were analyzed. EP pulse delivery increased short-term HRV: Poincare plot descriptor SD1 and HRV time-domain parameter SDSD, most likely due to electric stimulation with EP pulses, which transiently increased heart rate. Administration of bleomycin did not provoke any arrhythmias in ECG or changes in HRV. The statistically significant difference of all analyzed HRV parameters before and after ECT was obtained that could be explained by the influence of different factors on HRV (drugs, pain, activity of the patient). We can conclude that the entire procedure (which includes also intra-abdominal ECT treatment) has short- and long-term effects on HRV.