Incomplete atrioventricular dissociation and isorhythmic atrioventricular dissociation during general anesthesia with desflurane and remifentanil: A case report

We encountered a patient who experienced incomplete atrioventricular (A-V) dissociation and isorhythmic A-V dissociation during general anesthesia with desflurane and remifentanil. A 38-year-old man was scheduled to undergo extraction of both the upper and the right lower impacted wisdom teeth under general anesthesia. After anesthesia induction, we maintained anesthesia with desflurane and remifentanil. After 15 min, incomplete A-V dissociation was observed on electrocardiography (ECG). After atropine sulfate 0.3 mg was administered intravenously, isorhythmic A-V dissociation was observed. Atropine sulfate 0.2 mg was administered intravenously, and we observed normal ECG findings. Subsequently, no abnormal ECG findings were observed.