Artifactual 'atrial flutter' caused by a continuous passive motion device after total knee replacement.

摘要

We report a case of spurious electrocardiogram (ECG) abnormality in an 82-year-old man who underwent total knee replacement. He had hypertension and diabetes which was well controlled by oral medications. The patient also had two episodes of atrial fibrillation a few months earlier, treated with oral amiodarone and beta-blocker therapy. He was in normal sinus rhythm at the time of surgery, which was carried out under combined spinal epidural anaesthesia without adverse intraoperative event. He was transferred to the post-anaesthesia care unit where he maintained reasonable haemodynamic parameters. The attending anaesthetist subsequently noted a change in the cardiac rhythm of the patient to atrial flutter (Figure 1). Arterial blood gases, serum potassium and other electrolytes were normal. We decided to not to intervene because the ventricular rate appeared normal and regular.