AUTONOMIC NERVOUS ACTIVITY AND QT DISPERSION ATCOMMON BILE DUCT TREATMENT DURING ENDOSCOPICRETROGRADE CHOLANGIOPANCREATICOGRAPHY:CORRELATION WITH CARDIAC ACCIDENTS

摘要

Cause of cardiac accidents during endoscopic treatment of common bile duct under endoscopic retrograde cholangiopancreaticogaphy (ERCP) was examined from the view points of QT dispersion, spectral analysis of heart rate variability. Twenty-three patients undergone ERCP were studied. Electrocardiographic data during ERCP procedure was analyzed using QT analysis software. The changes of QTc dispersion, autonomic nervous parameter from spectral analysis of heart rate variability (LF, HE, LF/HF) and serum catecnolamine levels were analyzed (before endoscopic insertion, at insertion, stomach passage, duodenum achievement of endoscopy, canulation of papilla fater, during common bile duct treatment and immediately after pulling out endoscopy). QTc dispersion was significantly increased during all phage of ERCP procedure, especially during common bile duct treatment. The HF power during ERCP procedure was decreased and decreasing ratio of HF power showed significant inverse correlation with the change of QTc dispersion (r=-0.54, p<0.05). However, there was no correlation in increasing ratio of catecholamine and LF/HF, indicating that LF/HF could not become an index of sympathethic nervous activity. These results suggest that endoscopic common bile duct treatment gives rise to increase QTc dispersion and decreasing HF power, and arrthymogenic condition might occur.