In general, endoscopies are associated with cardiac arrhythmias, particularly colonoscopy. In current practice, it is not uncommon to get called upon to do a bronchoscopy in patients with angina or a recent myocardial infarction. A knowledge of the incidence and the type of arrhythmia occurring during the bronchoscopy will help us plan appropriately.
The occurrence of endoscopically induced arrhythmias and ischemic changes has been well documented in both gastroscopy and colonoscopy. A fiberoptic bronchoscopy, with the additional factor of airway intubation, might be assumed to be just as arrhythmogenic or ischemia provoking as colonoscopy.
Our data does not confirm this hypothesis. Although 40% of our patients had a minor arrhythmia during the bronchoscopy, no arrhythmia was life-threatening, i.e., no episode of ventricular tachycardia, asystole or marked bradycardia occurred.
The avoidance of hypoxemia by routine use of supplemental oxygen, generally deeper level of sedation, and the use of lidocaine as topical anesthetic are all factors that may be of importance of arrhythmias between colonoscopy and bronchoscopy.
However regulatory agencies require close monitoring of oxygen sats, BP and pulse, EKG and level of consciousness in all situations where consious sedation is done for the procedure. Hence routinely patients are monitored with finger transcutaneous oximeter and EKG monitor.