• Huanhuan Zhang, Meng Zhang, Yanru Du, Jinhua He, and Jianli Li.
• Department of Anesthesiology, Hebei General Hospital, Shijiazhuang City, Hebei Province, China.
• Medicine (Baltimore). 2023 Aug 25; 102 (34): e34775e34775.

RationaleDespite various advantages of laparoscopic surgical procedures, artificial pneumoperitoneum might lead to hemodynamic fluctuations including severe bradycardia and cardiac arrest. Atropine is usually proposed to treat intraoperative severe bradycardia ( < 40 beats per minute). However, atropine could induce ventricular arrhythmias, which might be life-threatening in severe case.Patient ConcernsHere, we reported a 41-year-old female who was diagnosed with gallbladder polyps and was scheduled for laparoscopic cholecystectomy under general anesthesia.DiagnosesBradycardia occurred suddenly during the operation and atropine was injected intravenously. Eventually the patient developed ventricular tachycardia and acute heart failure.InterventionsWe organized an urgent consultation and the patient was treated immediately.OutcomesFortunately, the patient experienced no complications after timely diagnosis and treatment. After 6 months of follow-up, her New York Heart Association classification was I with no complications.LessonsThis case highlighted that the administration of atropine to treat bradycardia may lead to ventricular tachycardia and acute heart failure, and anesthesiologists should remain vigilant to avoid potentially life-threatening consequences.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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