Rapid Ventricular Pacing During Cerebral Aneurysm Surgery: a Study Concerning the Safety for Heart and Brain
Rapid Ventricular Pacing During Cerebral Aneurysm Surgery: a Study Concerning the Safety for Heart and Brain
Rapid ventricular pacing (RVP) is a technique to obtain flow arrest for short periods of time
 during dissection or rupture of the aneurysm. RVP results in an adequate fall in blood
 pressure which presents as an on-off phenomenon. However it is not clear whether repetitive
 periods of pacing are harmless for the patient. Silent cardiac and cerebral infarcts may be
 undetected. The investigators will study the safety of RVP, particularly for the heart and
 the brain.
Rapid ventricular pacing (RVP) is a technique to obtain flow arrest for short periods of time
 during dissection or rupture of the aneurysm. RVP results in an adequate fall in blood
 pressure which presents as an on-off phenomenon. The technique facilitates the dissection and
 manipulation of cerebral aneurysms and arteriovenous malformations (AVMs) and can be
 lifesaving in the case of an intraoperative bleeding or rupture. In a former study blood
 pressure and clinical outcome were used as study parameters. However it is not clear whether
 repetitive periods of pacing are harmless for the patient. Silent cardiac and cerebral
 infarcts may be undetected if only clinical outcome is taken as a study parameter. The
 investigators will study the safety of RVP, particularly for the heart and the brain, using
 magnetic resonance imaging, brain oxygenation (Sct O₂) evaluated by near-infrared
 spectroscopy and troponin levels. The purpose of this study is to evaluate the effect of
 repetitive periods of RVP on the oxygenation of the heart and brain using magnetic resonance
 imaging, Sct O2 (3) and troponin levels (4) both markers for ischemia damage.
Inclusion Criteria:

 -  elective cerebral aneurysm clipping surgery

 -  arteriovenous malformation surgery

 -  craniotomy

 -  American Society of Anesthesiologists 1,2 and 3

 Exclusion Criteria:

 -  cardiac abnormalities

 -  coronary heart disease

 -  valvular heart disease

 -  pregnancy