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Increase in prominence of electrocardiographic J waves after a single dose of propofol in a patient with early ventricular repolarisation

Anaesthesia, ISSN: 0003-2409, Vol: 69, Issue: 2, Page: 170-175
2014
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Article Description

J waves appear on an electrocardiogram as an elevation of the J point in the terminal portion of the QRS complex. J waves are often benign, but may be associated with malignant ventricular arrhythmias. In some cases, such problems appear to have been precipitated by propofol infusions. We observed a sudden increase in J waves and profound hypotension following a single intravenous dose of propofol in an 84-year-old woman with early repolarisation in the inferior ventricular wall. When early repolarisation (as shown by electrocardiographic J waves) is observed in the inferior ventricular wall pre-operatively, patients should be carefully monitored. Myocardial ischaemia and the use of drugs that might worsen J waves should be avoided. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

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