Anesthetic Management with Remimazolam in an Arrhythmogenic Right Ventricular Cardiomyopathy Patient with a History of Stable Sustained Ventricular Tachycardia: A Case Report

Aims: Arrhythmogenic right ventricular cardiomyopathy (ARVC) may cause sudden and unexpected deaths during the perioperative period. This study reports a case of ARVC, safely managed using total intravenous anesthesia with remimazolam.

Presentation of Case: A 51-year-old male patient (weight: 100.1 kg, height: 171.0 cm) with a history of ARVC underwent open cholecystectomy. The patient underwent total intravenous anesthesia with remimazolam, remifentanil, and a modified thoracoabdominal nerves block perichondrial approach for postoperative analgesia. Hemodynamic stability was maintained throughout the surgery. Catecholamine use was not warranted during the perioperative period. No episodes of stable sustained ventricular tachycardia or other cardiovascular episodes were observed.

Discussion and Conclusion: ARVC is a genetically-determined heart muscle disease characterized by life-threatening ventricular arrhythmias in apparently healthy young people. Anesthesiologists should pay close attention to the anesthetic management of patients with ARVC. Remimazolam can be safely used in such cases.