[A case of sinus arrest during a surgical operation].

A 75-year old obese female was scheduled for mastectomy due to breast tumor. At the preoperative examinations, she had premature atrial contraction on electrocardiogram. But she had no clinical signs or symptoms regarding sick sinus syndrome. She was evaluated as ASA risk II and arranged for neuroleptanesthesia. During the operation, she developed severe bradycardia and asystole lasting for 7 seconds, which was not effectively controlled by atropine sulfate. Then cardiac rhythm resumed spontaneously and she recovered with no neurological deficits. On the postoperative examination of 24 hr-Holter ECG, she showed bradycardia and sinus arrest and she was diagnosed to have sick sinus syndrome.